Dental Specialists of Central Florida

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN19187 Issued in FL

Legal business name

DENTAL SPECIALISTS OF CENTRAL FLORIDA

Practice address

455 Magnolia Ave
Merritt Island, FL 32952-4838

Phone

(321) 453-7750

Fax

(321) 453-4966

NPI assigned

Oct 15, 2010

Last updated

Oct 15, 2010By 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

Mr. Jonathan Ouellette

Title

Owner

Phone

(321) 453-7750

Specialties & licenses 3

Addresses

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.

• Paul Ludwig Ouellette, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Merritt Island, FL
  • NPI 1861617409
  NPD (past)

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1336459064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 MAGNOLIA AVE",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524838",
            "telephone_number": "321-453-7750",
            "fax_number": "321-453-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 MAGNOLIA AVE",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524838",
            "telephone_number": "321-453-7750",
            "fax_number": "321-453-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF CENTRAL FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-453-7750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19069",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19187",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH17841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Delk, M.D.
• Justene Delman, D.C.
• Sophia Demartino
• Angela Dennis, APRN
• Dental Practice Group of Florida
• Elaine Deremer Cook, PE
• Anthony Devinney
• Lisa Lyn Devins, PHLEBOTOMIST
• Sharlene Diaz
• Digital Hearin Instruments

• General Practice Dentistry in Merritt Island, FL
• Providers in Merritt Island, 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 Oct 15, 2010; 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.