Organization Active NPI

My Dentist of West Lake Worth, PLLC

  • Dental Clinic/Center
  • Wellington, FL
National Provider Identifier
1285468629
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MY DENTIST OF WEST LAKE WORTH, PLLC
Practice address
8487 Lake Worth Rd
Suite 100
Wellington, FL 33467
Phone
(561) 275-5042
Fax
(561) 257-3883
NPI assigned
Aug 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Jordan Tomalty, DMD
Title
Ceo
Phone
(561) 633-9676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

8487 Lake Worth Rd
Suite 100
Wellington, FL 33467

Mailing address

8487 Lake Worth Rd
Suite 100
Wellington, FL 33467
Phone (561) 275-5042

Other names 1

  • My Dentist of West Lake Worth Doing business as

National Provider Directory

National Provider Directory

Locations

8487 Lake Worth Rd
Ste 100
Wellington, FL 33467
Phone (561) 275-5042

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1285468629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8487 LAKE WORTH RD",
            "address_2": "SUITE 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-275-5042",
            "fax_number": "561-257-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8487 LAKE WORTH RD",
            "address_2": "SUITE 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-275-5042",
            "fax_number": "561-257-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DENTIST OF WEST LAKE WORTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "TOMALTY",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-633-9676",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Dentist of West Lake Worth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.