NPIMap

Organization Active NPI

Children and Teen Dental Group of Florida

Doing business as Palm Tree Dentistry

  • General Practice Dentistry
  • Brooksville, FL
National Provider Identifier
1376127118
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
Doing business as
Palm Tree Dentistry
Practice address
13063 Cortez Blvd
Brooksville, FL 34613-4838
Phone
(352) 666-1400
Fax
(352) 666-0600
NPI assigned
May 7, 2021
Last updated
Sep 9, 2026By the provider in NPPES
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
General Practice Dentistry 1223G0001X NU Primary
Pediatric Dentistry 1223P0221X NU

Addresses

Primary practice location

13063 Cortez Blvd
Brooksville, FL 34613-4838

Mailing address

2300 Lakeview Pkwy Ste 250
Alpharetta, GA 30009-3954
Phone (470) 207-3264

Other practice location 1

5456 Spring Hill Dr
Spring Hill, FL 34606-4559
Phone (352) 666-1400

Other names 1

  • Palm Tree Dentistry Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1376127118",
    "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": "470-207-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13063 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346134838",
            "telephone_number": "352-666-1400",
            "fax_number": "352-666-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5456 Spring Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "FL",
            "postal_code": "346064559",
            "country_code": "US",
            "telephone_number": "352-666-1400",
            "fax_number": "352-666-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "2021-05-07",
        "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": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Tree Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooksville, 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.