Refresh Dental Lounge Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

REFRESH DENTAL LOUNGE GROUP LLC

Practice address

520 East Church St.
Suite 102a
Orlando, FL 32801

Phone

(407) 794-9459

Fax

(407) 794-9459

NPI assigned

Jul 19, 2023

Organization subpart

No

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

Authorized official

Name

John Constantine, DMD

Title

Owner

Phone

(407) 644-7703

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1316627938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 N LAKEMONT AVE STE B",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923203",
            "telephone_number": "407-644-7703",
            "fax_number": "407-644-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 EAST CHURCH ST.",
            "address_2": "SUITE 102A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32801",
            "telephone_number": "407-794-9459",
            "fax_number": "407-794-9459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFRESH DENTAL LOUNGE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "CONSTANTINE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-644-7703",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Orlando, FL
• Providers in Orlando, 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 Jul 19, 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.