Family Dentistry of Port Charlotte

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18310 Issued in FL

Legal business name

FAMILY DENTISTRY OF PORT CHARLOTTE

Practice address

2300 Tamiami TRL # 13&14
Port Charlotte, FL 33952-3900

Phone

(941) 209-5353

Fax

(941) 866-6838

NPI assigned

Oct 24, 2017

Last updated

Oct 24, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin J Krause

Title

Owner

Phone

(863) 773-9344

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1497267942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 TAMIAMI TRL # 13&14",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339523900",
            "telephone_number": "941-209-5959",
            "fax_number": "941-866-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 TAMIAMI TRL # 13&14",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339523900",
            "telephone_number": "941-209-5353",
            "fax_number": "941-866-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY OF PORT CHARLOTTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "KRAUSE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-773-9344",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Port Charlotte, FL
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• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.