NPIMap

Organization Active NPI

Advanced Dental Care Shady Road LLC

  • Dentist
  • Ocala, FL
National Provider Identifier
1457514986
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ADVANCED DENTAL CARE SHADY ROAD LLC
Practice address
3040 SW 27TH Ave
Ste 101
Ocala, FL 34471-8981
Phone
(941) 756-3410
NPI assigned
Jul 3, 2008
Last updated
Sep 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Authorized official

Name
Mike Cole
Title
Insurance Director
Phone
(727) 726-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

3040 SW 27TH Ave
Ste 101
Ocala, FL 34471-8981

Mailing address

3040 SW 27TH Ave
Ste 101
Ocala, FL 34471-8981
Phone (941) 756-3410

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3040 SW 27th Ave
Ste 101
Ocala, FL 34471
Phone (352) 237-7241

Practitioners & affiliated clinicians

Practitioners 2

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": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1457514986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 SW 27TH AVE",
            "address_2": "STE 101",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344718981",
            "telephone_number": "941-756-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 SW 27TH AVE",
            "address_2": "STE 101",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344718981",
            "telephone_number": "941-756-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL CARE SHADY ROAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.