Organization Active NPI

First Class Kids Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Brandon, FL
National Provider Identifier
1619833159
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
FIRST CLASS KIDS PEDIATRIC DENTISTRY PLLC
Practice address
1779 S Kings Ave
Brandon, FL 33511-6220
Phone
(813) 554-5437
Fax
(813) 554-5477
NPI assigned
Dec 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Authorized official

Name
Dorothy Theogene, DDSNPI 1699055004
Title
Owner/Pediatric Dentist
Phone
(954) 610-9441

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1779 S Kings Ave
Brandon, FL 33511-6220

Mailing address

1779 S Kings Ave
Brandon, FL 33511-6220
Phone (813) 554-5437

National Provider Directory

National Provider Directory

Locations

1779 S Kings Ave
Brandon, FL 33511
Phone (813) 554-5437

Practitioners & affiliated clinicians

Practitioners 1

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": "1766966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1619833159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116220",
            "telephone_number": "813-554-5437",
            "fax_number": "813-554-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116220",
            "telephone_number": "813-554-5437",
            "fax_number": "813-554-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CLASS KIDS PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "THEOGENE",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "954-610-9441",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "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 Dec 29, 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.