NPIMap

Organization Active NPI

Kidz Choice Pediatric Dentistry of Central Florida

  • Dental Clinic/Center
  • Orlando, FL
National Provider Identifier
1194157222
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN18945 Issued in FL
Legal business name
KIDZ CHOICE PEDIATRIC DENTISTRY OF CENTRAL FLORIDA
Practice address
508 N Mills Ave
Suite B
Orlando, FL 32803-5353
Phone
(407) 422-2617
Fax
(407) 841-6843
NPI assigned
Jul 31, 2013
Last updated
Jul 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Jeresia ChoiceNPI 1841587730
Title
Owner
Phone
(407) 422-2617

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
Dental Clinic/Center 261QD0000X DN18945 FL Primary

Addresses

Primary practice location

508 N Mills Ave
Suite B
Orlando, FL 32803-5353

Mailing address

508 N Mills Ave
Suite B
Orlando, FL 32803-5353

Other identifiers 1

IdentifierTypeStateIssuer
008810400MedicaidFL

National Provider Directory

National Provider Directory

Locations

508 N Mills Ave
Ste B
Orlando, FL 32803
Phone (407) 422-2617

Practitioners & affiliated clinicians

Practitioners 2

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": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1194157222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N MILLS AVE",
            "address_2": "SUITE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 N MILLS AVE",
            "address_2": "SUITE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035353",
            "telephone_number": "407-422-2617",
            "fax_number": "407-841-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ CHOICE PEDIATRIC DENTISTRY OF CENTRAL FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "CHOICE",
        "authorized_official_first_name": "JERESIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-422-2617"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN18945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008810400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.