NPIMap

Organization Active NPI

Children and Teen Dental Group of Florida

  • General Practice Dentistry
  • Winter Haven, FL
National Provider Identifier
1336722388
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Practice address
727 3Rd St SW
Winter Haven, FL 33880-3419
Phone
(863) 644-4739
NPI assigned
Apr 28, 2021
Organization subpart
Yes
Parent organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Jennifer Jordan Rogers
Title
Credentialing Specialist
Phone
(470) 801-4637

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X

Addresses

Primary practice location

727 3Rd St SW
Winter Haven, FL 33880-3419

Mailing address

2300 Lakeview Pkwy Ste 250
Alpharetta, GA 30009-3954
Phone (727) 784-2721

National Provider Directory

National Provider Directory
Tax ID family
Children and Teen Dental Group of Florida10 organizations share this tax ID, including this one
Part of
Children and Teen Dental Group of Florida

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

737 3rd St SW
Winter Haven, FL 33880
Phone (863) 644-4739

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1336722388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LAKEVIEW PKWY STE 250",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300093954",
            "telephone_number": "727-784-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 3RD ST SW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803419",
            "telephone_number": "863-644-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN AND TEEN DENTAL GROUP OF FLORIDA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN AND TEEN DENTAL GROUP OF FLORIDA",
        "enumeration_date": "2021-04-28",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JORDAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "470-801-4637"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.