NPIMap

Organization Active NPI

Poinciana Dental, LLC

  • Point of Service
  • Poinciana, FL
National Provider Identifier
1043528680
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
DN15940 Issued in FL
Legal business name
POINCIANA DENTAL, LLC
Practice address
873 Cypress Pkwy
Poinciana, FL 34759-3408
Phone
(407) 846-4775
NPI assigned
Sep 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Authorized official

Name
Dr. Christina Boesch, DMD
Title
Dentist
Phone
(407) 846-4775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X DN15940 FL Primary

Addresses

Primary practice location

873 Cypress Pkwy
Poinciana, FL 34759-3408

Mailing address

873 Cypress Pkwy
Poinciana, FL 34759-3408
Phone (407) 846-4775

National Provider Directory

National Provider Directory
Tax ID family
Poinciana Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1043528680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 CYPRESS PKWY",
            "city": "POINCIANA",
            "state": "FL",
            "postal_code": "347593408",
            "telephone_number": "407-846-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 CYPRESS PKWY",
            "city": "POINCIANA",
            "state": "FL",
            "postal_code": "347593408",
            "telephone_number": "407-846-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POINCIANA DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "BOESCH",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "407-846-4775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "DN15940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poinciana, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.