NPIMap

Organization Active NPI

Itd Associates, P.a.

Doing business as Indrio Dental Care

  • General Practice Dentistry
  • Fort Pierce, FL
National Provider Identifier
1073832176
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ITD ASSOCIATES, P.A.
Doing business as
Indrio Dental Care
Practice address
4832 N. Kings Highway
Fort Pierce, FL 34951
Phone
(772) 468-6226
Fax
(772) 468-6226
NPI assigned
May 28, 2010
Last updated
Apr 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Mr. Thomas Michael Hickey, DMDNPI 1346528692
Title
President
Phone
(772) 359-8962

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4832 N. Kings Highway
Fort Pierce, FL 34951

Mailing address

499 NW Prima Vista Blvd.
Port Saint Lucie, FL 34983
Phone (772) 335-7392

Other names 1

  • Indrio Dental Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1073832176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 NW PRIMA VISTA BLVD.",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34983",
            "telephone_number": "772-335-7392",
            "fax_number": "888-610-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4832 N. KINGS HIGHWAY",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34951",
            "telephone_number": "772-468-6226",
            "fax_number": "772-468-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITD ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "HICKEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-359-8962",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indrio Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.