NPIMap

Organization Active NPI

Main Street Children's Dentistry of Wellington

  • Pediatric Dentistry
  • Wellington, FL
National Provider Identifier
1629272349
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
MAIN STREET CHILDREN'S DENTISTRY OF WELLINGTON
Practice address
12788 W Forest Hill Blvd
Wellington, FL 33414-4703
Phone
(561) 422-2940
Fax
(561) 422-2945
NPI assigned
Jun 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Melody Parrish
Title
Office Manager
Phone
(305) 274-2499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X FL Primary

Addresses

Primary practice location

12788 W Forest Hill Blvd
Wellington, FL 33414-4703

Mailing address

12788 W Forest Hill Blvd
Wellington, FL 33414-4703
Phone (561) 422-2940

National Provider Directory

National Provider Directory
Tax ID family
Main Street Children's Dentistry of Wellington3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

12788 Forest Hill Blvd
West Palm Bch, FL 33414
Phone (561) 422-2940

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629272349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12788 W FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144703",
            "telephone_number": "561-422-2940",
            "fax_number": "561-422-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12788 W FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144703",
            "telephone_number": "561-422-2940",
            "fax_number": "561-422-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY OF WELLINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARRISH",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.