Pamela Ottesen DMD LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PAMELA OTTESEN DMD LLC

Practice address

1536 John Sims Pkwy
Niceville, FL 32578

Phone

(850) 582-1009

NPI assigned

Mar 21, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Pamela Ottesen, DMDNPI 1952441453

Title

Dentist

Phone

(850) 582-1009

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Pamela Alicia Ottesen, D.M.D.

  • General Practice Dentistry
  • Niceville, FL
  • NPI 1952441453
  NPD Authorized official

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1538586136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 KILDARE CIR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787308",
            "telephone_number": "850-582-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 JOHN SIMS PKWY",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-582-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA OTTESEN DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-21",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "OTTESEN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "850-582-1009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Alicia Ottesen, D.M.D.
• P3 Physical Therapy LLC
• P31 Life
• Jenna Pace, PHARMD
• Rachel Quinn Padilla, MSW
• Rachel Parden
• Danielle Parisi, COTA/L
• Partin Place Operations, LLC
• Kaitlyn Partin
• Pat T. Tidwell MD PA

• Dentist in Niceville, FL
• Providers in Niceville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.