NPIMap

Organization Active NPI

Marina Dental Center Inc.

  • Dentist
  • Daytona Beach Shores, FL
National Provider Identifier
1023382603
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN13724 Issued in FL
Legal business name
MARINA DENTAL CENTER INC.
Practice address
2570 S Atlantic Ave
Daytona Beach Shores, FL 32118-5523
Phone
(386) 304-2677
Fax
(386) 304-1899
NPI assigned
Feb 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Dr. Wafiek Nakhla, DMD
Title
Dr/Owner
Phone
(386) 304-2677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN13724 FL Primary

Addresses

Primary practice location

2570 S Atlantic Ave
Daytona Beach Shores, FL 32118-5523

Mailing address

2570 S Atlantic Ave
Daytona Beach Shores, FL 32118-5523
Phone (386) 304-2677

National Provider Directory

National Provider Directory

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": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1023382603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321185523",
            "telephone_number": "386-304-2677",
            "fax_number": "386-304-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321185523",
            "telephone_number": "386-304-2677",
            "fax_number": "386-304-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA DENTAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "NAKHLA",
        "authorized_official_first_name": "WAFIEK",
        "authorized_official_title_or_position": "DR/OWNER",
        "authorized_official_telephone_number": "386-304-2677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN13724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.