NPIMap

Organization Active NPI

Pediatric Dental Group

  • Pediatric Dentistry
  • Winter Park, FL
National Provider Identifier
1376946244
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL GROUP
Practice address
5518 Lake Howell Rd
Winter Park, FL 32792-1036
Phone
(407) 737-7767
Fax
(407) 737-0769
NPI assigned
Oct 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Authorized official

Name
Olubisi Aina, DMDNPI 1427255694
Title
Owner
Phone
(407) 737-7767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X FL Primary

Addresses

Primary practice location

5518 Lake Howell Rd
Winter Park, FL 32792-1036

Mailing address

5518 Lake Howell Rd
Winter Park, FL 32792-1036
Phone (407) 737-7767

Other names 1

  • Pediatric Dental Group Winter Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Dental Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

5518 Lake Howell Rd
Winter Park, FL 32792
Phone (407) 737-7767

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1376946244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5518 LAKE HOWELL RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327921036",
            "telephone_number": "407-737-7767",
            "fax_number": "407-737-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5518 LAKE HOWELL RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327921036",
            "telephone_number": "407-737-7767",
            "fax_number": "407-737-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "AINA",
        "authorized_official_first_name": "OLUBISI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-737-7767",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Group Winter Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.