Marina Dental & Denture Clinic PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MARINA DENTAL & DENTURE CLINIC PA

Practice address

25 Causeway Blvd
Suite 20
Clearwater Beach, FL 33767-2099

Phone

(727) 441-8225

Fax

(727) 441-8225

NPI assigned

Dec 7, 2006

Organization subpart

No

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

Authorized official

Name

David S Petrik, DDS

Title

President of Corporation

Phone

(727) 441-8225

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275692154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CAUSEWAY BLVD",
            "address_2": "SUITE 20",
            "city": "CLEARWATER BEACH",
            "state": "FL",
            "postal_code": "337672099",
            "telephone_number": "727-441-8225",
            "fax_number": "727-441-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CAUSEWAY BLVD",
            "address_2": "SUITE 20",
            "city": "CLEARWATER BEACH",
            "state": "FL",
            "postal_code": "337672099",
            "telephone_number": "727-441-8225",
            "fax_number": "727-441-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA DENTAL & DENTURE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETRIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "727-441-8225",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holiday CVS LLC
• Brian Hulsey
• I.S.a. Interpreting Services of America, Inc
• Mohamed Abdel Hakeem Khalaf, MD
• L.I.N. Legal Interpreting Network, LLC
• Kim O'Leesky, RN
• Eve M Persak, MS RDN CNSC CSSD
• Physicians Wellness Center, LLC
• Aleksander Precaj, DDS
• Aryk Rivoli-Johnson

• All providers in Clearwater Beach, FL
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.