Churchill Pediatric Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN19038 Issued in FL

Legal business name

CHURCHILL PEDIATRIC DENTISTRY LLC

Practice address

1371 SW 43Rd PL
Ocala, FL 34471-7501

Phone

(352) 274-9731

NPI assigned

Oct 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca J Tarver, DMD

Title

Owner

Phone

(352) 274-9731

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1381190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381190400000",
    "number": "1487081352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 SW 43RD PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717501",
            "telephone_number": "352-274-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 SW 43RD PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717501",
            "telephone_number": "352-274-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHILL PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-08",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "TARVER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-274-9731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002880200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher M. Pell, LLC
• Chronic Care Solutions
• CHS
• Andrew Chu
• Sooyoung Peter Chung, M.D.
• Laurence Harold Churchill, D.C.
• Thomas Chwe, O.D.
• Justin Cibik, APRN, CNP
• Caterina Ciccone, ARNP
• Maria Cintron, CMT

• General Practice Dentistry in Ocala, FL
• Providers in Ocala, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.