NPIMap

Organization Active NPI

L & L Port Orange, LLC

Doing business as Kevin Marvin

  • Dental Clinic/Center
  • Port Orange, FL
National Provider Identifier
1043708050
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN7283 Issued in FL
Legal business name
L & L PORT ORANGE, LLC
Doing business as
Kevin Marvin
Practice address
4904 S Clyde Morris Blvd
Suite B
Port Orange, FL 32129
Phone
(386) 788-9959
Fax
(386) 788-9850
NPI assigned
Apr 25, 2018
Last updated
Apr 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Authorized official

Name
Dr. Eugene Joseph Lecompte Jr., DDS, MS
Title
Owner/Manager
Phone
(386) 295-3815

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN7283 FL Primary
Dental Clinic/Center 261QD0000X DN12922 FL

Addresses

Primary practice location

4904 S Clyde Morris Blvd
Suite B
Port Orange, FL 32129

Mailing address

3890 Turtle Creek Drive
Suite a
Port Orange, FL 32127
Phone (386) 761-5440

Other names 1

  • Kevin Marvin Doing business as

National Provider Directory

National Provider Directory

Locations

4904 Clyde Morris Blvd
Ste B
Port Orange, FL 32129
Phone (386) 788-9959

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": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1043708050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 TURTLE CREEK DRIVE",
            "address_2": "SUITE A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32127",
            "telephone_number": "386-761-5440",
            "fax_number": "386-760-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 S CLYDE MORRIS BLVD",
            "address_2": "SUITE B",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32129",
            "telephone_number": "386-788-9959",
            "fax_number": "386-788-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L & L PORT ORANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "LECOMPTE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "386-295-3815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN7283",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN12922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kevin Marvin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.