Wildwood Modern Dentistry, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WILDWOOD MODERN DENTISTRY, PA

Practice address

5297 Sundance TRL
Wildwood, FL 34785-7717

Phone

(352) 663-9773

NPI assigned

Jan 10, 2025

Organization subpart

No

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

Authorized official

Name

Jerin Joseph

Title

Owner

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samah Nabeel Yousef, DMD

  • Dentist
  • Wildwood, FL
  • NPI 1427949262
  NPD

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1063222149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5297 SUNDANCE TRL",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857717",
            "telephone_number": "352-663-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "JERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellness by Physicians, Inc.
• West Florida Medical Associates, PA
• Mary Margaret Wheeler, LCSW
• Wildwood Family Psychiatry, PLLC
• Wildwood Hearing LLC
• Wildwood Primary Care Associates
• Wildwood SNF LLC
• Wildwood SNF LLC
• Melissa Wilkes
• Molly Jane Wilkinson, NP

• General Practice Dentistry in Wildwood, FL
• Providers in Wildwood, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.