NPIMap

Organization Active NPI

Seacrest Dental

  • Dental Clinic/Center
  • Santa Rosa Beach, FL
National Provider Identifier
1366844854
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN 20813 Issued in FL
Legal business name
SEACREST DENTAL
Practice address
5399 E County Highway 30a
Santa Rosa Beach, FL 32459-6717
Phone
(850) 231-3736
NPI assigned
Sep 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Dr. Fred Ruder
Title
Owner
Phone
(850) 231-3736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN 20813 FL Primary

Addresses

Primary practice location

5399 E County Highway 30a
Santa Rosa Beach, FL 32459-6717

Mailing address

5399 E County Highway 30a
Santa Rosa Beach, FL 32459-6717

National Provider Directory

National Provider Directory
Tax ID family
Seacrest Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1366844854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5399 E COUNTY HIGHWAY 30A",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324596717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5399 E COUNTY HIGHWAY 30A",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324596717",
            "telephone_number": "850-231-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACREST DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "RUDER",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-231-3736",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN 20813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.