NPIMap

Organization Active NPI

Everglades Pediatric Dentistry II

Doing business as Everglades Pediatric Dentistry

  • Pediatric Dentistry
  • Sebring, FL
National Provider Identifier
1588029300
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN16660 Issued in FL
Legal business name
EVERGLADES PEDIATRIC DENTISTRY II
Doing business as
Everglades Pediatric Dentistry
Practice address
5606 US Highway 27 N
Sebring, FL 33870-1211
Phone
(863) 382-0340
Fax
(863) 357-7342
NPI assigned
Dec 21, 2015
Last updated
Dec 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Dr. Melissa Danielle Kindell, DMDNPI 1205805504
Title
Owner/Dentist
Phone
(863) 382-0340

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
Pediatric Dentistry 1223P0221X DN16660 FL Primary

Addresses

Primary practice location

5606 US Highway 27 N
Sebring, FL 33870-1211

Mailing address

5606 US Highway 27 N
Sebring, FL 33870-1211
Phone (863) 382-0340

Other identifiers 1

IdentifierTypeStateIssuer
1223P0221XMedicaidFL

Other names 1

  • Everglades Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Everglades Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5606 US 27 N
Sebring, FL 33870
Phone (863) 382-0340

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1588029300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 US HIGHWAY 27 N",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338701211",
            "telephone_number": "863-382-0340",
            "fax_number": "863-357-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 US HIGHWAY 27 N",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338701211",
            "telephone_number": "863-382-0340",
            "fax_number": "863-357-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGLADES PEDIATRIC DENTISTRY II",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "KINDELL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "863-382-0340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN16660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1223P0221X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everglades Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.