NPIMap

Organization Active NPI

Imagine Orthodontic Studio PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Largo, FL
National Provider Identifier
1154047819
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
IMAGINE ORTHODONTIC STUDIO PLLC
Practice address
1581 Missouri Ave N
Largo, FL 33770-1853
Phone
(727) 724-2400
NPI assigned
Oct 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Authorized official

Name
Michael Andrew Hess, DMD, MS
Title
Owner
Phone
(727) 743-8307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1581 Missouri Ave N
Largo, FL 33770-1853

Mailing address

7348 US 19 N
Pinellas Park, FL 33781-4600
Phone (727) 865-5711

Other identifiers 1

IdentifierTypeStateIssuer
108070900MedicaidFL

Other names 1

  • Imagine Orthodontic Studio Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.imagineorthostudio.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Imagine Orthodontic Studio PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1581 Missouri Ave N
Largo, FL 33770
Phone (727) 724-2400

Practitioners & affiliated clinicians

Practitioners 1

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": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1154047819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7348 US 19 N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814600",
            "telephone_number": "727-865-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 MISSOURI AVE N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337701853",
            "telephone_number": "727-724-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE ORTHODONTIC STUDIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "HESS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-743-8307",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108070900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.imagineorthostudio.com",
            "affiliation": "N",
            "endpointDescription": "company website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1581 Missouri Ave N",
            "city": "Largo",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337701853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Imagine Orthodontic Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.