Organization Active NPI

Destin Dentistry, PLLC

  • Dentist
  • Destin, FL
National Provider Identifier
1063334787
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DESTIN DENTISTRY, PLLC
Practice address
14081 Emerald Coast Pkwy Ste a
Destin, FL 32541-8541
Phone
(850) 654-6969
NPI assigned
Jul 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Peter Kelly, DDS
Title
Owner
Phone
(407) 432-6224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

14081 Emerald Coast Pkwy Ste a
Destin, FL 32541-8541

Mailing address

14081 Emerald Coast Pkwy Ste a
Destin, FL 32541-8541

National Provider Directory

National Provider Directory

Locations

14081 Emerald Coast Pkwy
Ste A
Destin, FL 32541

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1063334787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14081 EMERALD COAST PKWY STE A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14081 EMERALD COAST PKWY STE A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418541",
            "telephone_number": "850-654-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTIN DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-432-6224",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.