Individual provider Active NPI

Philip Blaine Dahlquist, DMD

  • General Practice Dentistry
  • New Smyrna Beach, FL
National Provider Identifier
1083812333
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN31053 Issued in FL
Practice address
2327 FL 44
New Smyrna Beach, FL 32168
Phone
(386) 957-5720
NPI assigned
Jul 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN31053 FL Primary

Addresses

Primary practice location

2327 FL 44
New Smyrna Beach, FL 32168

Mailing address

2327 FL 44
Deland, FL 07840-2632
Phone (386) 308-2441

Other identifiers 1

IdentifierTypeStateIssuer
DN31053MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN31053FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1183939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1083812333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2327 FL 44",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "078402632",
            "telephone_number": "386-308-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 FL 44",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "32168",
            "telephone_number": "386-957-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLQUIST",
        "first_name": "PHILIP",
        "middle_name": "BLAINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-09",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN31053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DN31053",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.