Forst Park Dental PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21936 Issued in FL

Legal business name

FORST PARK DENTAL PA

Practice address

2620 Jenks Ave
Panama City, FL 32405-4311

Phone

(850) 785-8586

Fax

(334) 281-1087

NPI assigned

Jul 13, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Susan M Stewart

Title

Office Manager

Phone

(334) 281-2451

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1194177212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054311",
            "telephone_number": "850-785-8586",
            "fax_number": "334-281-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054311",
            "telephone_number": "850-785-8586",
            "fax_number": "334-281-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORST PARK DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-281-2451",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forest Park Medical Associates
• Forest Park Smiles on 11TH, PLLC
• Forget-Me-Not Dementia Clinic and Other Neurology Services LLC
• Anna Alise Forgue
• Tiffany Diane Forrester, M.D.
• Jenna Lee Foster, M.S., CCC-SLP
• John A Foster, EMT-P
• Four Pillars Healthcare PLLC
• Chantelle Fowler
• Joshua Fowler I

• General Practice Dentistry in Panama City, FL
• Providers in Panama City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.