Main Street Children's Dentistry and Orthodontics of Clermont, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CLERMONT, PLLC

Practice address

2410 E Highway 50, BLDG D, Suite a
Clermont, FL 34711

Phone

(305) 274-2499

NPI assigned

Jun 7, 2016

Last updated

Jun 24, 2016By 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

Stephanie Gomez

Title

Credentialing Coordinator

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Maria Ortiz, DDS

  • Pediatric Dentistry
  • Clermont, FL
  • NPI 1821557851
  NPD (past)

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1275982670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864461",
            "telephone_number": "305-274-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 E HIGHWAY 50, BLDG D, SUITE A",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "305-274-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF CLERMONT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam Lucia Machado, BCBA
• Norma Indira Madera, LMHC
• Rehenakhanu Madhani, PHARMD
• Magnolia Foot Care, LLC
• Jessica Mahabal
• Jessica Maisonave, MD
• Kar Shun Constant Mak, MD
• Mohammed Said Malas, M.D.
• Sonia E Malave, MA, CCC/SLP
• Keydith Maldonado Rodriguez

• Pediatric Dentistry in Clermont, FL
• Providers in Clermont, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.