NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

Doing business as Dental Care at Lake Ingram

  • General Practice Dentistry
  • Winter Garden, FL
National Provider Identifier
1043046451
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Doing business as
Dental Care at Lake Ingram
Practice address
17075 Porter Rd Ste 130
Winter Garden, FL 34787
Phone
(689) 946-0010
Fax
(689) 946-0009
NPI assigned
Sep 11, 2024
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

17075 Porter Rd Ste 130
Winter Garden, FL 34787

Mailing address

17075 Porter Rd Ste 130
Winter Garden, FL 34787

Other names 1

  • Dental Care at Lake Ingram Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionalspa459 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionalspa

Organizations with this tax ID in the same state 24

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

View all 24

Locations

17075 Porter Rd
Ste 130
Winter Garden, FL 34787
Phone (689) 946-0010

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1043046451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 PORTER RD STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 PORTER RD STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787",
            "telephone_number": "689-946-0010",
            "fax_number": "689-946-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Lake Ingram",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.