Sand Mine Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SAND MINE DENTISTRY, PLLC

Practice address

49591 Highway 27 Ste 301
Davenport, FL 33897-9507

Phone

6

NPI assigned

Jun 5, 2023

Last updated

Jun 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter Kelly

Title

Owner

Phone

(407) 432-6224

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1255025235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49591 HIGHWAY 27 STE 301",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338979507",
            "telephone_number": "6"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49591 HIGHWAY 27 STE 301",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338979507",
            "telephone_number": "6"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND MINE DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-432-6224"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Hilda Cruz Sanabria
• Ricardo R Sanchez Maceira, M.D.
• Dioleisy Sanchez Suarez
• Jesus David Sanchez
• Tatiana Janeth Sanchez, FNP-C
• Daniel Sandoval Ramos, APRN
• Valerie Sanes, MS ED.
• Zolanye Rafelina Santana Betances, MD
• Briana Santana
• Rafael Alberto Santiago Aponte, MD

• Dental Clinic/Center in Davenport, FL
• Providers in Davenport, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.