Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

Doing business as Boggy Creek Dental Care

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1295375780
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Doing business as
Boggy Creek Dental Care
Practice address
13670 Boggy Creek Rd
Orlando, FL 32824-9203
Phone
(689) 205-5590
NPI assigned
Jan 13, 2020
Last updated
Apr 14, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

13670 Boggy Creek Rd
Orlando, FL 32824-9203

Mailing address

13670 Boggy Creek Rd
Orlando, FL 32824-9203
Phone (407) 800-0129

Other names 1

  • Boggy Creek Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionalspa459 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionalspa

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

13670 Boggy Creek Rd
Orlando, FL 32824
Phone (689) 205-5590

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1295375780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13670 BOGGY CREEK RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328249203",
            "telephone_number": "407-800-0129",
            "fax_number": "407-374-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13670 BOGGY CREEK RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328249203",
            "telephone_number": "689-205-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boggy Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boggy Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.