Eustis Family Dental Spa, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

EUSTIS FAMILY DENTAL SPA, LLC

Practice address

600 N Eustis St
Eustis, FL 32726-2908

Phone

(352) 357-1212

NPI assigned

May 28, 2021

Organization subpart

No

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

Authorized official

Name

James Magee III, DDS

Title

Doctor

Phone

(352) 357-1212

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1356917512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N EUSTIS ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327262908",
            "telephone_number": "352-357-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N EUSTIS ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327262908",
            "telephone_number": "352-357-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUSTIS FAMILY DENTAL SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "MAGEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "352-357-1212",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Eustis, FL
• Providers in Eustis, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.