NPIMap

Organization Active NPI

Brandon Advanced Dental Care PA

  • Dentist
  • Brandon, FL
National Provider Identifier
1619001484
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRANDON ADVANCED DENTAL CARE PA
Practice address
625 Medical Care Dr
Brandon, FL 33511-5942
Phone
(813) 662-3599
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Authorized official

Name
Mike Cole
Title
Insurance Director
Phone
(727) 726-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

625 Medical Care Dr
Brandon, FL 33511-5942

Mailing address

625 Medical Care Dr
Brandon, FL 33511-5942

National Provider Directory

National Provider Directory

Locations

625 Medical Care Dr
Brandon, FL 33511
Phone (727) 726-1611

Practitioners & affiliated clinicians

Practitioners 4

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311552000000",
    "number": "1619001484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MEDICAL CARE DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MEDICAL CARE DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115942",
            "telephone_number": "813-662-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON ADVANCED DENTAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-07-25",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.