Wekiva Place, PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN10359 Issued in FL

Legal business name

WEKIVA PLACE, PA

Practice address

686 N Hunt Club Blvd
Wekiva Place, Suite 100
Longwood, FL 32779-2218

Phone

(407) 869-7333

Fax

(407) 869-5720

NPI assigned

Jul 17, 2013

Organization subpart

Yes

Parent organization

WEKIVA PLACE, PAAs reported in NPPES

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

Authorized official

Name

Dr. Mark S. Offenback, D.D.S.NPI 1205847621

Title

President

Phone

(407) 869-7333

Specialties & licenses 1

Addresses

Other names 1

• Wekiva Dental Doing business as

Part of

Wekiva Place PA

Locations

Practitioners 1

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

• Mark Steven Offenback, DDS PA

  • General Practice Dentistry
  • Longwood, FL
  • NPI 1205847621
  NPD (past) Authorized official

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1346681491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 N HUNT CLUB BLVD",
            "address_2": "WEKIVA PLACE, SUITE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327792218",
            "telephone_number": "407-869-7333",
            "fax_number": "407-869-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 N HUNT CLUB BLVD",
            "address_2": "WEKIVA PLACE, SUITE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327792218",
            "telephone_number": "407-869-7333",
            "fax_number": "407-869-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEKIVA PLACE, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEKIVA PLACE, PA",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "OFFENBACK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-869-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wekiva Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Riley Webster, RBT
• Wendy Weeks, LMT
• Richard Weise II, DPT
• Lora Ellen Weiss, OTR/L
• Megan Weiss, MOT, OTR/L, CLT-LANA
• Faith Wells
• Nneka Wells, OTR/L
• Wellspring Health & Integrative Medicine, LLC
• Katherine M Welty, MD
• Wesley Peter Blitchington, PH.D.

• Dentist in Longwood, FL
• Providers in Longwood, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.