NPIMap

Organization Active NPI

Florida Dental Sleep Disorders, P.a.

  • Dentist
  • Melbourne, FL
National Provider Identifier
1255178950
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FLORIDA DENTAL SLEEP DISORDERS, P.A.
Practice address
1400 Pine St
Melbourne, FL 32901-3170
Phone
(321) 265-3462
NPI assigned
Jul 10, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Yitta Garden, DMDNPI 1073955589
Title
Owner
Phone
(561) 400-7816

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
Dentist 122300000X Primary

Addresses

Primary practice location

1400 Pine St
Melbourne, FL 32901-3170

Mailing address

21861 Cypress Palm CT
Boca Raton, FL 33428-2938
Phone (561) 400-7816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240917001956 FL Part B Supplier - Clinic/Group Practice 0749721876 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boca Raton, FL; Melbourne, FL; Vero Beach, FL
O20251106000052 FL DME Supplier - Oral Surgery - Dentist 0749721876 Practice locations: Melbourne, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Florida Dental Sleep Disorders PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1400 Pine St
Melbourne, FL 32901
Phone (321) 265-3462

787 37th St
Ste E180
Vero Beach, FL 32960
Phone (772) 226-7195

Practitioners & affiliated clinicians

Practitioners 5

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": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1255178950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21861 CYPRESS PALM CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282938",
            "telephone_number": "561-400-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013170",
            "telephone_number": "321-265-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DENTAL SLEEP DISORDERS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "GARDEN",
        "authorized_official_first_name": "YITTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-400-7816",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.