International Center for Complete Dentistry

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

DN4596 Issued in FL

Legal business name

INTERNATIONAL CENTER FOR COMPLETE DENTISTRY

Practice address

111 2ND Ave NE
#1104
Saint Petersburg, FL 33701-3434

Phone

(727) 821-4433

Fax

(727) 822-7252

NPI assigned

Feb 16, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Dreama Michelle Wegzyn

Title

RN, Office Manager

Phone

(727) 821-4433

Specialties & licenses 1

Addresses

Other identifiers 7

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberley Danley Daxon, D.D.S.

  • Prosthodontics
  • Saint Petersburg, FL
  • NPI 1952426439
  NPD (past)
• Glenn Dupont, D.D.S.

  • General Practice Dentistry
  • Saint Petersburg, FL
  • NPI 1295851293
  NPD (past)
• Carley Jeff Scott, D.M.D.

  • General Practice Dentistry
  • Saint Petersburg, FL
  • NPI 1679692461
  NPD (past)
• Dewitt Wilkerson, D.M.D

  • General Practice Dentistry
  • Saint Petersburg, FL
  • NPI 1770602567
  NPD (past)

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1154643377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "address_2": "#1104",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "727-821-4433",
            "fax_number": "727-822-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "address_2": "#1104",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "727-821-4433",
            "fax_number": "727-822-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL CENTER FOR COMPLETE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "WEGZYN",
        "authorized_official_first_name": "DREAMA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "RN, OFFICE MANAGER",
        "authorized_official_telephone_number": "727-821-4433",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "FL",
            "license": "DN4596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477679470",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770602567",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6301580001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679692461",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952426439",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1295851293",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154643377",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intercoastal Urgent Care Associates PL
• Inthefeeling LLC
• Patricia Iorio, LMT
• Shari Ann Iovino, LCSW
• Sarah Irani, M.D.
• Irecovery, LLC

• Customized Equipment (DME) in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Customized Equipment (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.