NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, PA

Doing business as Complete Dental Care

  • General Practice Dentistry
  • Port Charlotte, FL
National Provider Identifier
1477736643
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Doing business as
Complete Dental Care
Practice address
1940 Tamiami Trail
Suite 102
Port Charlotte, FL 33948-2105
Phone
(941) 625-7413
Fax
(941) 625-2417
NPI assigned
Dec 11, 2007
Last updated
Sep 15, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X FL Primary

Addresses

Primary practice location

1940 Tamiami Trail
Suite 102
Port Charlotte, FL 33948-2105

Mailing address

1940 Tamiami Trail
Suite 102
Port Charlotte, FL 33948-2105
Phone (941) 625-7413

Other names 1

  • Complete Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionals PA457 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionals PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1940 Tamiami Trl
Ste 102
Port Charlotte, FL 33948
Phone (941) 625-7413

Practitioners & affiliated clinicians

Practitioners 7

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": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1477736643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 TAMIAMI TRAIL",
            "address_2": "SUITE 102",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482105",
            "telephone_number": "941-625-7413",
            "fax_number": "941-625-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 TAMIAMI TRAIL",
            "address_2": "SUITE 102",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482105",
            "telephone_number": "941-625-7413",
            "fax_number": "941-625-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA",
        "enumeration_date": "2007-12-11",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.