Sundance Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18740 Issued in FL

Legal business name

SUNDANCE FAMILY DENTISTRY

Practice address

5380 Stadium Pkwy
Suite 119
Viera, FL 32955-6001

Phone

(321) 837-3700

NPI assigned

Dec 23, 2015

Organization subpart

No

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

Authorized official

Name

Christopher Ryan Osorio, DMD

Title

Dentist/Owner

Phone

(321) 837-3700

Specialties & licenses 2

Addresses

Practitioners 1

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

• Kaitlin Donovan, DMD

  • General Practice Dentistry
  • Rockledge, FL
  • NPI 1750888970
  NPD (past)

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1386009017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 STADIUM PKWY",
            "address_2": "SUITE 119",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329556001",
            "telephone_number": "321-837-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 STADIUM PKWY",
            "address_2": "SUITE 119",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329556001",
            "telephone_number": "321-837-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "OSORIO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "321-837-3700",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18740",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kai-Wyn Annika Sterling, CPHT
• Karen Marie Stewart, FNP-C
• Cecilia Joycelyn Stinson
• Kathy June Styles, RPH
• Jessica Mae Sullivan, AU.D.
• Lorinda Dawn Teicher, M.D.
• Joann Corinne Teller, R.D.
• Sandra Teuber, LCSW, CAP
• The Devereux Foundation
• The Devereux Foundation

• General Practice Dentistry in Viera, FL
• Providers in Viera, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.