Dental Store Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN15874 Issued in FL

Legal business name

DENTAL STORE INC

Doing business as

East Boca Dental

Practice address

2151 NW 2ND Ave
Suite 102
Boca Raton, FL 33431

Phone

(561) 395-1486

Fax

(561) 395-1525

NPI assigned

Feb 8, 2007

Last updated

May 27, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George Soropoulos, DDSNPI 1255472783

Title

President/General Dentist

Phone

(561) 395-1486

Specialties & licenses 5

Addresses

Other names 1

• East Boca Dental Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Agean Dental of Coral Springs

  • Dentist
  • Coral Springs, FL
  • NPI 1679977821
  NPPES parent name

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.

• George Soropoulos, DDS

  • General Practice Dentistry
  • Boca Raton, FL
  • NPI 1255472783
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1063552727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 NW 2ND AVE",
            "address_2": "SUITE 102",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33431",
            "telephone_number": "561-395-1486",
            "fax_number": "561-395-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 NW 2ND AVE",
            "address_2": "SUITE 102",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33431",
            "telephone_number": "561-395-1486",
            "fax_number": "561-395-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "SOROPOULOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT/GENERAL DENTIST",
        "authorized_official_telephone_number": "561-395-1486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN6099",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15874",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN8030",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN17801",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN16973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Boca Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dental Care 4 You LLC
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• Dental Concepts PA
• Dental First Care 4 PA
• Dental Horizons, Inc
• Dental Team of West Palm Beach
• Dental Urgent Care, PLLC
• Dentalmed Associates LLC
• Dentists of Boca Village, PA (Dentists of Boca Village)
• Douglas F Deorchis, M.D.

• General Practice Dentistry in Boca Raton, FL
• Providers in Boca Raton, 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 May 27, 2009; 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.