NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

  • Endodontics
  • Port Saint Lucie, FL
National Provider Identifier
1619769460
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Practice address
1465 NW Saint Lucie West Blvd
Port Saint Lucie, FL 34986-1968
Phone
(772) 210-9370
NPI assigned
May 19, 2025
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1465 NW Saint Lucie West Blvd
Port Saint Lucie, FL 34986-1968

Mailing address

1465 NW Saint Lucie West Blvd
Port Saint Lucie, FL 34986-1968

Other names 1

  • Gankin Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Denta Health Professionals PA455 organizations share this tax ID, including this one
Part of
Comfortable Care Denta Health Professionals PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1619769460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 NW SAINT LUCIE WEST BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 NW SAINT LUCIE WEST BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861968",
            "telephone_number": "772-210-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gankin Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.