NPIMap

Organization Active NPI

Healthy Smiles Dental of Palm Coast LLC

  • Dentist
  • Palm Coast, FL
National Provider Identifier
1386034635
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN18114 Issued in FL
Legal business name
HEALTHY SMILES DENTAL OF PALM COAST LLC
Practice address
1264 Palm Coast Pkwy SW
Palm Coast, FL 32137-4700
Phone
(386) 283-4902
Fax
(386) 283-4961
NPI assigned
Jan 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Authorized official

Name
Mrs. Luciana Benchimol
Title
Office Manager
Phone
(386) 283-4902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN18114 FL Primary

Addresses

Primary practice location

1264 Palm Coast Pkwy SW
Palm Coast, FL 32137-4700

Mailing address

1264 Palm Coast Parkway SW
Palm Coast, FL 32137
Phone (386) 283-4902

National Provider Directory

National Provider Directory

Locations

1264 Palm Coast Pkwy SW
Palm Coast, FL 32137
Phone (386) 283-4902

Practitioners & affiliated clinicians

Practitioners 2

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": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1386034635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 PALM COAST PARKWAY SW",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "386-283-4902",
            "fax_number": "386-283-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 PALM COAST PKWY SW",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374700",
            "telephone_number": "386-283-4902",
            "fax_number": "386-283-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SMILES DENTAL OF PALM COAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "BENCHIMOL",
        "authorized_official_first_name": "LUCIANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-283-4902",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.