NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, PC

Doing business as St. Lucie Family Dental

  • Dentist
  • Port St Lucie, FL
National Provider Identifier
1023430261
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20237 Issued in FL
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PC
Doing business as
St. Lucie Family Dental
Practice address
10457 S US Highway 1
Port St Lucie, FL 34952-5645
Phone
(772) 236-6394
NPI assigned
Jan 7, 2014
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Allison Varner
Title
Credentialing Coordinator
Phone
(217) 540-6077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20237 FL Primary

Addresses

Primary practice location

10457 S US Highway 1
Port St Lucie, FL 34952-5645

Mailing address

10457 S US Highway 1
Port St Lucie, FL 34952-5645
Phone (772) 236-6394

Other names 1

  • St. Lucie Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionals PA457 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionals PA

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

10457 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 236-6394

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1023430261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10457 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525645",
            "telephone_number": "772-236-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10457 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525645",
            "telephone_number": "772-236-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PC",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "VARNER",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6077"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Lucie Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.