Progressive Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROGRESSIVE DENTAL, LLC

Doing business as

Progressive Dental

Practice address

8511 S Federal Hwy
Port Saint Lucie, FL 34952-3346

Phone

(772) 878-5880

Fax

(772) 878-7475

NPI assigned

Mar 15, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Karla Concepcion

Title

Billing Coordinator

Phone

(772) 878-5880

Specialties & licenses 1

Addresses

Other names 1

• Progressive Dental Doing business as

Locations

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1245539303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523346",
            "telephone_number": "772-878-5880",
            "fax_number": "772-878-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523346",
            "telephone_number": "772-878-5880",
            "fax_number": "772-878-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "772-878-5880",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Port Saint Lucie, FL
• Providers in Port Saint Lucie, 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 Mar 15, 2011; 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.