NPIMap

Organization Active NPI

Your Dentist Inc

  • Dentist
  • South Daytona, FL
National Provider Identifier
1023189693
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6899 Issued in FL
Legal business name
YOUR DENTIST INC
Practice address
310 Bellewood Ave
South Daytona, FL 32119
Phone
(386) 760-5511
Fax
(386) 760-7848
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Dr. Michael T Maccaro, DMDNPI 1376947697
Title
Owner President of Corp Dentist
Phone
(386) 760-5511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6899 FL Primary

Addresses

Primary practice location

310 Bellewood Ave
South Daytona, FL 32119

Mailing address

310 Bellewood Ave
South Daytona, FL 32119
Phone (386) 760-5511

National Provider Directory

National Provider Directory

Locations

310 Bellewood Ave
South Daytona, FL 32119
Phone (386) 760-5511

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1023189693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BELLEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "32119",
            "telephone_number": "386-760-5511",
            "fax_number": "386-760-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BELLEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "32119",
            "telephone_number": "386-760-5511",
            "fax_number": "386-760-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR DENTIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "MACCARO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER PRESIDENT OF CORP DENTIST",
        "authorized_official_telephone_number": "386-760-5511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "6899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.