NPIMap

Organization Active NPI

Panther Hollow Dental Lodge, PL

  • General Practice Dentistry
  • Port Charlotte, FL
National Provider Identifier
1265671887
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PANTHER HOLLOW DENTAL LODGE, PL
Practice address
19240 Quesada Ave
Port Charlotte, FL 33948-3126
Phone
(941) 743-7435
Fax
(941) 743-7429
NPI assigned
Feb 5, 2009
Last updated
Jul 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Authorized official

Name
Dr. Joseph C Bender, DMDNPI 1225244957
Title
Owner
Phone
(941) 743-7435

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
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

19240 Quesada Ave
Port Charlotte, FL 33948-3126

Mailing address

19240 Quesada Ave
Port Charlotte, FL 33948-3126
Phone (941) 743-7435

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1265671887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19240 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483126",
            "telephone_number": "941-743-7435",
            "fax_number": "941-743-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19240 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483126",
            "telephone_number": "941-743-7435",
            "fax_number": "941-743-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANTHER HOLLOW DENTAL LODGE, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-743-7435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.