Distinctive Dentistry of Sanford

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9352 Issued in FL

Legal business name

DISTINCTIVE DENTISTRY OF SANFORD

Practice address

200 W Lake Mary Blvd
Sanford, FL 32773-5925

Phone

(407) 330-1700

NPI assigned

Jan 13, 2007

Organization subpart

No

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

Authorized official

Name

Peter Weisbruch, DDSNPI 1295886760

Title

Owner

Phone

(407) 330-1700

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.

• Peter Weisbruch, DDS

  • General Practice Dentistry
  • Port Orange, FL
  • NPI 1295886760
  NPD (past) Authorized official

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386795854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735925",
            "telephone_number": "407-330-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735925",
            "telephone_number": "407-330-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE DENTISTRY OF SANFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEISBRUCH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-330-1700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "9352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dialysis Services of Central Florida
• Yuri Pamela Diaz Castro, SI 5871
• Nathalia Dibenardo, LMHC
• Breha Julie Diggs, DO
• Edward Dimauro II
• Divine Connection LLC.
• Amyris Dixon
• Erika M. Dodd, LMFT
• Vymarys J Dominguez, O.D.
• Jennifer Donnan

• General Practice Dentistry in Sanford, FL
• Providers in Sanford, 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 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.