East Coast Endodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN12743 Issued in FL

Legal business name

EAST COAST ENDODONTICS

Practice address

912 S Ridgewood Ave
Suite C
Daytona Beach, FL 32114-5349

Phone

(386) 252-0858

Fax

(386) 253-7004

NPI assigned

Jul 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roderick M Macintyre III, D.M.D.;M.S.NPI 1770597411

Title

Owner

Phone

(386) 252-0858

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, and the practitioner matching its NPPES authorized official.

• Roderick M Macintyre III, D.M.D.; M.S.

  • Endodontics
  • Daytona Beach, FL
  • NPI 1770597411
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386658284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S RIDGEWOOD AVE",
            "address_2": "SUITE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145349",
            "telephone_number": "386-252-0858",
            "fax_number": "386-253-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S RIDGEWOOD AVE",
            "address_2": "SUITE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145349",
            "telephone_number": "386-252-0858",
            "fax_number": "386-253-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACINTYRE",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-252-0858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.M.D.;M.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN12743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Earlywine, CRNA
• Rachel Easley
• East Central Florida Outpatient Imaging LLC (Twin Lakes Imaging Center)
• East Central Florida Outpatient Imaging LLC
• East Coast Bariatrics, Inc.
• East Coast Medical and Oxygen Therapies Inc
• East Coast Pathology of Florida
• Easter Seals
• Easter Seals of Volusia and Flagler Counties
• Easterseals Florida, Inc.

• Dental Clinic/Center in Daytona Beach, FL
• Providers in Daytona Beach, 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 Aug 22, 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.