NPIMap

Organization Active NPI

Platinum Dental Group

Doing business as Celebration Dental Group

  • Dentist
  • Celebration, FL
National Provider Identifier
1487057014
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DH 20940 Issued in FL
Legal business name
PLATINUM DENTAL GROUP
Doing business as
Celebration Dental Group
Practice address
2940 Mallory Cir
Suite 101
Celebration, FL 34747-1818
Phone
(407) 566-2222
NPI assigned
Sep 26, 2014
Last updated
Sep 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Dr. Mark D Huzyak, DMDNPI 1295862845
Title
Director
Phone
(407) 566-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DH 20940 FL Primary

Addresses

Primary practice location

2940 Mallory Cir
Suite 101
Celebration, FL 34747-1818

Mailing address

2940 Mallory Cir
Suite 101
Celebration, FL 34747-1818
Phone (407) 566-2222

Other names 1

  • Celebration Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

2940 Mallory Cir
Ste 101
Kissimmee, FL 34747
Phone (407) 566-2222

Practitioners & affiliated clinicians

Practitioners 1

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": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1487057014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 MALLORY CIR",
            "address_2": "SUITE 101",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471818",
            "telephone_number": "407-566-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 MALLORY CIR",
            "address_2": "SUITE 101",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471818",
            "telephone_number": "407-566-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "HUZYAK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-566-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DH 20940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Celebration Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Celebration, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.