Crestview Smiles, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CRESTVIEW SMILES, PA

Practice address

5170 S Ferdon Blvd
Crestview, FL 32536-9258

Phone

(850) 897-4488

NPI assigned

Jan 24, 2020

Organization subpart

No

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

Authorized official

Name

Lovelyn Silva

Title

Operations Manager

Phone

(850) 699-6111

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Olivier Broutin, D.M.D.

  • Dentist
  • Niceville, FL
  • NPI 1013927037
  NPD (past)

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1386274777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789735",
            "telephone_number": "850-897-4488",
            "fax_number": "850-897-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325369258",
            "telephone_number": "850-897-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW SMILES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "SILVA",
        "authorized_official_first_name": "LOVELYN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "850-699-6111"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crestview Pediatrics and Adolescent Center PA
• Crestview Pharmacy, LLC
• Crestview Physical and Aquatic Therapy LLC
• Crestview Physical Therapy Inc
• Crestview Rehabilitation Center, LLC
• Crestview Surgery Center LP (Crestview Surgery Center)
• Crestview Urgent Care, Inc.
• Crestview Vision Associates, LLC (Family Vision of Crestview)
• Jamie Michele Crissman
• Bailey Jo Renee Cronk

• Dental Clinic/Center in Crestview, FL
• Providers in Crestview, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.