NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

Doing business as Dental Care on Fennell

  • General Practice Dentistry
  • Lady Lake, FL
National Provider Identifier
1376158030
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Doing business as
Dental Care on Fennell
Practice address
625 N US Highway 441
Lady Lake, FL 32159-3714
Phone
(352) 633-8082
Fax
(352) 268-2114
NPI assigned
Sep 10, 2020
Last updated
Jan 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

625 N US Highway 441
Lady Lake, FL 32159-3714

Mailing address

625 N US Highway 441
Lady Lake, FL 32159-3714
Phone (352) 633-8082

Other names 1

  • Dental Care on Fennell Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionals PA457 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionals PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1376158030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593714",
            "telephone_number": "352-633-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593714",
            "telephone_number": "352-633-8082",
            "fax_number": "352-268-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2020-09-10",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care on Fennell",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Care on Fennell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.