Alligator Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ALLIGATOR DENTAL CORPORATION

Practice address

5245 41St St
Vero Beach, FL 32967-1619

Phone

(772) 202-9558

NPI assigned

Mar 19, 2024

Organization subpart

No

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

Authorized official

Name

Jared Woolf

Title

Owner

Phone

(949) 305-2253

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1619737640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 ARGONAUT STE 220",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926564105",
            "telephone_number": "949-305-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 41ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329671619",
            "telephone_number": "772-202-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIGATOR DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "WOOLF",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-305-2253"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.