NPIMap

Organization Active NPI

Clermont Kids Dentistry PA

  • Pediatric Dentistry
  • Clermont, FL
National Provider Identifier
1164998308
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CLERMONT KIDS DENTISTRY PA
Practice address
1655 E Hwy 50 Ste 101
Clermont, FL 34711-5056
Phone
(407) 446-6644
NPI assigned
Oct 15, 2018
Last updated
Oct 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Authorized official

Name
Dr. Faraz Tartibi, DMDNPI 1639520794
Title
Owner
Phone
(407) 446-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

1655 E Hwy 50 Ste 101
Clermont, FL 34711-5056

Mailing address

416 Harley CT
Oviedo, FL 32765-8359
Phone (407) 446-6644

National Provider Directory

National Provider Directory

Locations

1655 E Highway 50
Ste 101
Clermont, FL 34711
Phone (352) 241-4884

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": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1164998308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 HARLEY CT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658359",
            "telephone_number": "407-446-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 E HWY 50 STE 101",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115056",
            "telephone_number": "407-446-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLERMONT KIDS DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "TARTIBI",
        "authorized_official_first_name": "FARAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-446-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.