NPIMap

Organization Active NPI

Lake View Family Dentistry PA

  • General Practice Dentistry
  • Bayonet Point, FL
National Provider Identifier
1487750378
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14566 Issued in FL
Legal business name
LAKE VIEW FAMILY DENTISTRY PA
Practice address
13728 Office Park Court
Bayonet Point, FL 34667
Phone
(727) 863-9669
Fax
(727) 862-8907
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen M Durett, DMD
Title
President
Phone
(727) 863-9669

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN14566 FL Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN14685 FL

Addresses

Primary practice location

13728 Office Park Court
Bayonet Point, FL 34667

Mailing address

13728 Office Park Court
Bayonet Point, FL 34667
Phone (727) 863-9669

Other identifiers 2

IdentifierTypeStateIssuer
539393OtherFLUNITED HEALTH CARE
56988OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

13728 Office Park Ct
Bayonet Point, FL 34667
Phone (727) 863-9669

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487750378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13728 OFFICE PARK COURT",
            "city": "BAYONET POINT",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-863-9669",
            "fax_number": "727-862-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13728 OFFICE PARK COURT",
            "city": "BAYONET POINT",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-863-9669",
            "fax_number": "727-862-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VIEW FAMILY DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DURETT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-863-9669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14566",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14685",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "539393",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56988",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonet Point, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.