NPIMap

Organization Active NPI

Ocean Breeze Dental, PA

  • Dentist
  • Rockledge, FL
National Provider Identifier
1073875480
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19254 Issued in FL
Legal business name
OCEAN BREEZE DENTAL, PA
Practice address
817 Westport Dr
Rockledge, FL 32955-3501
Phone
(321) 433-1141
Fax
(321) 433-1210
NPI assigned
Jun 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Dr. Mary L Kalimnios, DMDNPI 1275618076
Title
Dentist/President
Phone
(321) 433-1141

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN15187 FL
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN19254 FL Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN19217 FL

Addresses

Primary practice location

817 Westport Dr
Rockledge, FL 32955-3501

Mailing address

817 Westport Dr
Rockledge, FL 32955-3501
Phone (321) 433-1141

National Provider Directory

National Provider Directory
Tax ID family
Mary L Kalimnios DMD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

817 Westport Dr
Rockledge, FL 32955
Phone (321) 433-1141

Practitioners & affiliated clinicians

Practitioners 5

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": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1073875480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 WESTPORT DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553501",
            "telephone_number": "321-433-1141",
            "fax_number": "321-433-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 WESTPORT DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553501",
            "telephone_number": "321-433-1141",
            "fax_number": "321-433-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN BREEZE DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "KALIMNIOS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "321-433-1141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15187",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19254",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.