NPIMap

Organization Active NPI

Pediatric Dentistry of Brandon PA

  • Pediatric Dentistry
  • Brandon, FL
National Provider Identifier
1467894980
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTISTRY OF BRANDON PA
Practice address
517 Corner Dr
Brandon, FL 33511-5718
Phone
(787) 398-7143
Fax
(813) 681-7213
NPI assigned
Jul 25, 2013
Last updated
Jul 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Ms. Kerry J Torres
Title
Practice Manager
Phone
(787) 398-7143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

517 Corner Dr
Brandon, FL 33511-5718

Mailing address

517 Corner Dr
Brandon, FL 33511-5718
Phone (787) 398-7143

National Provider Directory

National Provider Directory

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": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1467894980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 CORNER DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115718",
            "telephone_number": "787-398-7143",
            "fax_number": "813-681-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 CORNER DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115718",
            "telephone_number": "787-398-7143",
            "fax_number": "813-681-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF BRANDON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "787-398-7143",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.