Organization Active NPI

Ags Dentists of Ft. Pierce

Doing business as Midway Dental Center

  • Dental Clinic/Center
  • Fort Pierce, FL
National Provider Identifier
1164130522
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
AGS DENTISTS OF FT. PIERCE
Doing business as
Midway Dental Center
Practice address
5054 S 25TH St
Fort Pierce, FL 34981-4923
Phone
(772) 464-4822
NPI assigned
Nov 14, 2022
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Giovanna Dejesus
Title
Operations
Phone
(813) 340-0116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

5054 S 25TH St
Fort Pierce, FL 34981-4923

Mailing address

8794 Boynton Beach Blvd Ste 218
Boynton Beach, FL 33472-4469
Phone (561) 425-7999

Other names 1

  • Midway Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

2102 S 11th St
Fort Pierce, FL 34950
Phone (772) 461-0932

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1164130522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8794 BOYNTON BEACH BLVD STE 218",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724469",
            "telephone_number": "561-425-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5054 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814923",
            "telephone_number": "772-464-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGS DENTISTS OF FT. PIERCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "DEJESUS",
        "authorized_official_first_name": "GIOVANNA",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "813-340-0116"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midway Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.