NPIMap

Organization Active NPI

Davenport Dental Associates LLC

  • Dental Clinic/Center
  • Davenport, FL
National Provider Identifier
1508522368
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DAVENPORT DENTAL ASSOCIATES LLC
Practice address
2213 North Blvd W
Davenport, FL 33837-8990
Phone
(863) 256-3636
NPI assigned
Nov 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Authorized official

Name
Ivan ZamoraNPI 1881835262
Title
President
Phone
(305) 586-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2213 North Blvd W
Davenport, FL 33837-8990

Mailing address

2213 North Blvd W
Davenport, FL 33837-8990
Phone (863) 256-3636

National Provider Directory

National Provider Directory

Locations

2213 North Blvd W
Davenport, FL 33837
Phone (863) 256-3636

Practitioners & affiliated clinicians

Practitioners 2

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": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1508522368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 NORTH BLVD W",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378990",
            "telephone_number": "863-256-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 NORTH BLVD W",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378990",
            "telephone_number": "863-256-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-586-4500"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 16, 2021; 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.