Orbit Dental Management PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

ORBIT DENTAL MANAGEMENT PA

Practice address

1453 NW Saint Lucie West Blvd
Port St Lucie, FL 34986-1968

Phone

(772) 348-4403

Fax

(772) 348-4342

NPI assigned

Sep 1, 2020

Organization subpart

No

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

Authorized official

Name

Mikhail Gankin

Title

Owner

Phone

(772) 348-4403

Specialties & licenses 1

Addresses

Other names 1

• St. Lucie West Dental Specialists Doing business as

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1154935799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861968",
            "telephone_number": "772-348-4403",
            "fax_number": "772-348-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861968",
            "telephone_number": "772-348-4403",
            "fax_number": "772-348-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORBIT DENTAL MANAGEMENT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "GANKIN",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-348-4403"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Lucie West Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endodontics in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.