NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

Doing business as Dental Care at FishHawk Commons

  • General Practice Dentistry
  • Lithia, FL
National Provider Identifier
1063163418
Registry record updated Jan 17, 2022
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 FishHawk Commons
Practice address
5628 Circa Fishhawk Blvd
Lithia, FL 33547-4218
Phone
(813) 324-5795
NPI assigned
Jan 17, 2022
Last updated
Jan 17, 2022By 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 Jan 17, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

5628 Circa Fishhawk Blvd
Lithia, FL 33547-4218

Mailing address

5628 Circa Fishhawk Blvd
Lithia, FL 33547-4218
Phone (813) 324-5795

Other names 1

  • Dental Care at FishHawk Commons 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 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

5628 Circa Fishhawk Blvd
Lithia, FL 33547
Phone (813) 324-5795

Practitioners & affiliated clinicians

Practitioners 2

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": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1063163418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5628 CIRCA FISHHAWK BLVD",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474218",
            "telephone_number": "813-324-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5628 CIRCA FISHHAWK BLVD",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474218",
            "telephone_number": "813-324-5795"
        }
    ],
    "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": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at FishHawk Commons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lithia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.