NPIMap

Organization Active NPI

Comfortable Care Denta Health Professionals, PA

Doing business as Family Dental at Lakeside Village

  • General Practice Dentistry
  • Lakeland, FL
National Provider Identifier
1144547597
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA
Doing business as
Family Dental at Lakeside Village
Practice address
1375 Town Center Dr
Lakeland, FL 33803-7964
Phone
(863) 686-2162
Fax
(863) 686-2615
NPI assigned
Apr 26, 2010
Last updated
Apr 26, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLECARE DETAL HEALTH PROFESSIONALS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
Pam Hardiek
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

1375 Town Center Dr
Lakeland, FL 33803-7964

Mailing address

1375 Town Center Dr
Lakeland, FL 33803-7964
Phone (863) 686-2162

Other names 1

  • Family Dental at Lakeside Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionalspa459 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionalspa

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1375 Town Center Dr
Lakeland, FL 33803
Phone (210) 725-3055

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1144547597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 TOWN CENTER DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037964",
            "telephone_number": "863-686-2162",
            "fax_number": "863-686-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 TOWN CENTER DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037964",
            "telephone_number": "863-686-2162",
            "fax_number": "863-686-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLECARE DETAL HEALTH PROFESSIONALS, PA",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "HARDIEK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "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": "Family Dental at Lakeside Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.