Rennigade Dental Group PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RENNIGADE DENTAL GROUP PLLC

Practice address

1747 US Highway 1 S
St Augustine, FL 32084-4238

Phone

(904) 495-0881

NPI assigned

Oct 18, 2021

Organization subpart

No

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

Authorized official

Name

Kevon Rennie

Title

Owner

Phone

(904) 495-0881

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karim Nashed, DDS

  • General Practice Dentistry
  • Winter Haven, FL
  • NPI 1538892005
  NPD (past)
• Samuel Shrewsbury, DMD

  • Dentist
  • St Augustine, FL
  • NPI 1437087665
  NPD (past)
• Rachel Leah Smith, D.M.D.

  • Dentist
  • St Augustine, FL
  • NPI 1225392889
  NPD (past)

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1316600356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 US HIGHWAY 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844238",
            "telephone_number": "904-495-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENNIGADE DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "RENNIE",
        "authorized_official_first_name": "KEVON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-495-0881"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Reimert, PT, OTR/L, DPT, MOT
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• Remedy Physiorooms LLC
• Renew Physical Therapy and Wellness LLC
• Renew Therapy Partners Inc
• Angela Maria Restivo, LMT
• Restore Community Counseling
• Luke Jared Retherford, OTR/L
• Charlie Lee Revay
• Karl Reyes, RN

• General Practice Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.