Professional Dental Alliance of FL - LMTD, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF FL - LMTD, PLLC

Doing business as

Lakewood Ranch Dental
Paul Hinder
Sorrento Dental Care

Practice address

12385 Sorrento Rd Ste B1
Pensacola, FL 32507-8656

Phone

(850) 492-7647

NPI assigned

Aug 18, 2023

Last updated

Jan 25, 2024By 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

Erica Quinteros

Title

Credentialing

Phone

(724) 901-1964

Specialties & licenses 2

Addresses

Other names 3

• Lakewood Ranch Dental Doing business as
• Paul Hinder Doing business as
• Sorrento Dental Care Doing business as

Locations

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1255115598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223",
            "telephone_number": "724-901-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12385 SORRENTO RD STE B1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325078656",
            "telephone_number": "850-492-7647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 3rd Ave N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322507043",
            "country_code": "US",
            "telephone_number": "904-247-3074",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6270 Lake Osprey Dr",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342408425",
            "country_code": "US",
            "telephone_number": "941-907-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF FL - LMTD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "QUINTEROS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "724-901-1964"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Ranch Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paul Hinder",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sorrento Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sorrento Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Pensacola, FL
• Providers in Pensacola, 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 Jan 25, 2024; 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.