NPIMap

Organization Active NPI

Bartlett Family and Cosmetic Dentistry, PLLC

Doing business as Bright Smiles Family and Cosmetic Dentistry

  • General Practice Dentistry
  • Fort Walton Beach, FL
National Provider Identifier
1437881950
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BARTLETT FAMILY AND COSMETIC DENTISTRY, PLLC
Doing business as
Bright Smiles Family and Cosmetic Dentistry
Practice address
208 Hospital Dr NE
Fort Walton Beach, FL 32548-5068
Phone
(850) 243-8124
NPI assigned
Jun 24, 2022
Last updated
Jun 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Authorized official

Name
Vicenta Reyes
Title
Credentialing Lead
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

208 Hospital Dr NE
Fort Walton Beach, FL 32548-5068

Mailing address

208 Hospital Dr NE
Fort Walton Beach, FL 32548-5068
Phone (850) 243-8124

Other names 1

  • Bright Smiles Family and Cosmetic Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

208 Hospital Dr NE
Ft Walton Bch, FL 32548
Phone (850) 243-8124

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1437881950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485068",
            "telephone_number": "850-243-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485068",
            "telephone_number": "850-243-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTLETT FAMILY AND COSMETIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "VICENTA",
        "authorized_official_title_or_position": "CREDENTIALING LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Smiles Family and Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.