Divine Chiropractic Health and Wellness PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

CH10414 Issued in FL

Legal business name

DIVINE CHIROPRACTIC HEALTH AND WELLNESS PLLC

Practice address

1820 E County Road 540a
Wellness
Lakeland, FL 33813-3737

Phone

(863) 670-5137

Fax

(863) 299-3016

NPI assigned

Aug 3, 2012

Last updated

Aug 21, 2015By 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

Samantha M Denstedt, DCNPI 1720363310

Title

Sole MBR

Phone

(863) 670-5137

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.

• Samantha Marie Denstedt, DC

  • Chiropractor
  • Lakeland, FL
  • NPI 1720363310
  Authorized official Same address or phone

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440115200000",
    "number": "1396091773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E COUNTY ROAD 540A",
            "address_2": "WELLNESS",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133737",
            "telephone_number": "863-670-5137",
            "fax_number": "863-299-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E COUNTY ROAD 540A",
            "address_2": "WELLNESS",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133737",
            "telephone_number": "863-670-5137",
            "fax_number": "863-299-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CHIROPRACTIC HEALTH AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2015-08-21",
        "status": "A",
        "authorized_official_last_name": "DENSTEDT",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "863-670-5137",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "CH10414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kay Disipio, PT
• Chester Becker Dissinger II, D.D.S.
• Amanda Mae Distin, APRN
• Kaitlyn Dittmer, DO
• Kathryn Divincenzo, DO
• Yasmin Divine, MD
• Charmethia Dixon
• Dustin J Dixon, OD
• John Christopher Dixon, LMHC
• Laura Dixon, APRN

• Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.