NPIMap

Organization Active NPI

Periodontal Health Center, PL

  • Periodontics
  • New Port Richey, FL
National Provider Identifier
1235440884
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN17194 Issued in FL
Legal business name
PERIODONTAL HEALTH CENTER, PL
Practice address
5522 Gulf Dr
New Port Richey, FL 34652-4022
Phone
(727) 847-1239
Fax
(727) 845-4595
NPI assigned
Jun 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Dr. Jessica Stilley, DMDNPI 1881856029
Title
Periodontist
Phone
(727) 847-1239

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DN17194 FL Primary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DN6888 FL

Addresses

Primary practice location

5522 Gulf Dr
New Port Richey, FL 34652-4022

Mailing address

5522 Gulf Dr
New Port Richey, FL 34652-4022
Phone (727) 847-1239

National Provider Directory

National Provider Directory

Locations

5522 Gulf Dr
New Prt Rchy, FL 34652
Phone (727) 847-1239

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1235440884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 GULF DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524022",
            "telephone_number": "727-847-1239",
            "fax_number": "727-845-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5522 GULF DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524022",
            "telephone_number": "727-847-1239",
            "fax_number": "727-845-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL HEALTH CENTER, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "STILLEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "727-847-1239",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN17194",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN6888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.