Organization Active NPI

Healthy Smiles Dental of Port Saint Lucie FL PLLC

  • Dental Clinic/Center
  • Port Saint Lucie, FL
National Provider Identifier
1205554300
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HEALTHY SMILES DENTAL OF PORT SAINT LUCIE FL PLLC
Doing business as
Healthy Smiles Dental of Port Saint Lucie FL PLLC
Practice address
258 SW Port St Lucie Blvd
Port Saint Lucie, FL 34984-5044
Phone
(772) 877-0488
Fax
(772) 877-0814
NPI assigned
Aug 16, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Dr. Jacques Benchimol, DMDNPI 1780841940
Title
Owner
Phone
(954) 397-1452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

258 SW Port St Lucie Blvd
Port Saint Lucie, FL 34984-5044

Mailing address

8495 Twin Lake Dr
Boca Raton, FL 33496-1923
Phone (954) 397-1452

Other names 1

  • Healthy Smiles Dental of Port Saint Lucie FL PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

258 SW Port St Lucie Blvd
Port Saint Lucie, FL 34984
Phone (772) 877-0488

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": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1205554300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8495 TWIN LAKE DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334961923",
            "telephone_number": "954-397-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349845044",
            "telephone_number": "772-877-0488",
            "fax_number": "772-877-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SMILES DENTAL OF PORT SAINT LUCIE FL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "BENCHIMOL",
        "authorized_official_first_name": "JACQUES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-397-1452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Smiles Dental of Port Saint Lucie FL PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.