Krystal Clear Dental P.L.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16987 Issued in FL

Legal business name

KRYSTAL CLEAR DENTAL P.L.

Practice address

19445 Shumard Oak Dr
Land O Lakes, FL 34638-7262

Phone

(813) 849-3695

NPI assigned

Jul 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Krystelle Terry Duvert, DDS

Title

Dentist

Phone

(813) 849-3695

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1417110537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18838 DUQUESNE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473421",
            "telephone_number": "813-849-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19445 SHUMARD OAK DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387262",
            "telephone_number": "813-849-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRYSTAL CLEAR DENTAL P.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "DUVERT",
        "authorized_official_first_name": "KRYSTELLE",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "813-849-3695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "16987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Korah
• Debra Johnson Kotter, RRT
• Edmund John Kozlowski III, LMT
• Paige Krause
• Luci Krueger, PHARM.D.
• Deborah Marie Kuhlman, LCSW
• Colleen Kurtz, LCSW
• Kyc Rehabilitation Center
• Suzette Lynn La Russa, OTR/L
• Greetter Labra Rosales

• General Practice Dentistry in Land O Lakes, FL
• Providers in Land O Lakes, 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 Jul 9, 2008; 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.