Park Street Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DN11980 Issued in FL

Legal business name

PARK STREET DENTAL

Practice address

4911 Park St N
Suite a
St Petersburg, FL 33709-2227

Phone

(727) 548-7733

Fax

(727) 548-0015

NPI assigned

May 2, 2016

Organization subpart

No

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

Authorized official

Name

Jose M Garcia, DDS

Title

Owner

Phone

(727) 548-7733

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1154776730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 PARK ST N",
            "address_2": "SUITE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092227",
            "telephone_number": "727-548-7733",
            "fax_number": "727-548-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 PARK ST N",
            "address_2": "SUITE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092227",
            "telephone_number": "727-548-7733",
            "fax_number": "727-548-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK STREET DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-548-7733",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nick William Parilla, MD
• Don Edward Parish, D.O.
• Mackenzie Parish
• Park Home Healthcare,LLC
• Park Medical Surgery Center, LLC
• Park Street Women'S Center, P.a.
• Natalie Park, DPT
• Parker Behavioral Consulting, Inc.
• Latina Parker-Critton
• Susan A Parker-Singler, MS, BCBA

• Dentist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.