NPIMap

Organization Active NPI

Pimendent, PA

  • General Practice Dentistry
  • Lady Lake, FL
National Provider Identifier
1093062630
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17338 Issued in FL
Legal business name
PIMENDENT, PA
Practice address
560 N US Highway 27 # 441
Lady Lake, FL 32159-3776
Phone
(352) 259-1065
NPI assigned
Aug 14, 2012
Last updated
Aug 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Authorized official

Name
Ashley Cole
Title
Provider Relations Manager
Phone
(866) 273-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17338 FL Primary

Addresses

Primary practice location

560 N US Highway 27 # 441
Lady Lake, FL 32159-3776

Mailing address

PO Box 3189
Syracuse, NY 13220-3189

National Provider Directory

National Provider Directory

Locations

560 N US Highway 27/441
Lady Lake, FL 32159
Phone (352) 259-1065

Practitioners & affiliated clinicians

Practitioners 4

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": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1093062630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N US HIGHWAY 27 # 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593776",
            "telephone_number": "352-259-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIMENDENT, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PROVIDER RELATIONS MANAGER",
        "authorized_official_telephone_number": "866-273-8204"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.