Victus Dental II PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

VICTUS DENTAL II PA

Practice address

1308 West 9 Mile Rd Suite 9
Penscola, FL 32534-3253

Phone

(850) 484-4844

NPI assigned

Feb 9, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Le, DMDNPI 1366875221

Title

President

Phone

(201) 375-3363

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Nguyen Le, D.M.D

  • General Practice Dentistry
  • Pensacola, FL
  • NPI 1366875221
  NPD Authorized official
• Julie Ducker, DMD

  • General Practice Dentistry
  • Navarre, FL
  • NPI 1437776531
  NPD
• Taylor Anderson Newman, DMD, MMS

  • General Practice Dentistry
  • Pensacola, FL
  • NPI 1205407301
  NPD
• Kyle Penland, DMD

  • General Practice Dentistry
  • New Smyrna Beach, FL
  • NPI 1821611534
  NPD (past)

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1467917823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 MONROE ST STE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325147656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 WEST 9 MILE RD SUITE 9",
            "city": "PENSCOLA",
            "state": "FL",
            "postal_code": "325343253",
            "telephone_number": "850-484-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTUS DENTAL II PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-09",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-375-3363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025098900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Creahan

• All providers in Penscola, FL
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.