Havendale Dental Off PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN10392 Issued in FL

Legal business name

HAVENDALE DENTAL OFF PA

Practice address

7111 Cypress Garden Blvd
Winter Haven, FL 33884

Phone

(863) 324-7401

Fax

(863) 324-1024

NPI assigned

Dec 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dipak Vrajlal ShethNPI 1932288610

Title

President

Phone

(863) 324-7401

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dipak Vrajlal Sheth

  • General Practice Dentistry
  • Winter Haven, FL
  • NPI 1932288610
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023171584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 CYPRESS GARDEN BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33884",
            "telephone_number": "863-324-7401",
            "fax_number": "863-324-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 CYPRESS GARDEN BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33884",
            "telephone_number": "863-324-7401",
            "fax_number": "863-324-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENDALE DENTAL OFF PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHETH",
        "authorized_official_first_name": "DIPAK",
        "authorized_official_middle_name": "VRAJLAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-324-7401"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10392",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52172",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bita Hassani Ghaly
• Stephanie Padgett Hatten, APRN
• Kim Haufe, D.D.S
• Joseph William Hauter, D.O.
• Haven Enterprises, LLC
• Havendale Family Chiropractic LLC
• Kali Constanza Hawkins, PA-C
• Tenesia Hawthorne
• HB3 Beauty Luxe
• Health Holdings Company LLC

• General Practice Dentistry in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.