NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

  • General Practice Dentistry
  • Davenport, FL
National Provider Identifier
1487020871
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Practice address
7551 Osceola Polk Line Road
Davenport, FL 33896
Phone
(863) 852-1195
NPI assigned
Aug 19, 2015
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Carmen Woods
Title
Credentialing
Phone
(217) 540-5100

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

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

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Denta Health Professionals PA (455 organizations share this tax ID)
Part of
Comfortable Care Denta Health Professionals PA

Locations

7551 Osceola Polk Line Rd
Davenport, FL 33896
Phone (321) 401-4540

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

7551 Osceola Polk Line Road
Davenport, FL 33896

Mailing address

7551 Osceola Polk Line Road
Davenport, FL 33896

Other names 1

NPPES NPI Registry
  • Dental Care of Davenport Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2015.

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1487020871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7551 OSCEOLA POLK LINE ROAD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 OSCEOLA POLK LINE ROAD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "863-852-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "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": "Dental Care of Davenport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.