Pan Dental Services PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PAN DENTAL SERVICES PLLC

Doing business as

Pine Avenue Smiles

Practice address

190 Pine Ave N
Oldsmar, FL 34677-4629

Phone

(813) 855-1007

Fax

(813) 855-1009

NPI assigned

Aug 9, 2023

Last updated

Aug 9, 2023By 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

Michelle Pan, RN

Title

Office Manager

Phone

(813) 855-1007

Specialties & licenses 1

Addresses

Other names 1

• Pine Avenue Smiles Doing business as

Locations

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1407539133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 PINE AVE N",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774629",
            "telephone_number": "813-855-1007",
            "fax_number": "813-855-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 PINE AVE N",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774629",
            "telephone_number": "813-855-1007",
            "fax_number": "813-855-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAN DENTAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "813-855-1007",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Avenue Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pine Avenue Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Ottersbach
• Alicia D Owens, FNP
• Nanette Pacheco, RN
• Lauren Rose Paciorek, RD, LDN, CLC
• Palm Harbor/Oldsmar Urgent Care Corporation
• Andy Pan, DMD
• Ricky Pan, D.M.D.
• Ariel Alejandro Pardo Rogriguez
• Peak Minds LLC
• Pearl Grace Care LLC

• Dental Clinic/Center in Oldsmar, FL
• Providers in Oldsmar, 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 9, 2023; 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.