Winter Haven Modern Dentistry, PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WINTER HAVEN MODERN DENTISTRY, PA

Doing business as

Winter Haven Modern Dentistry

Practice address

565 Cypress Gardens Blvd
Winter Haven, FL 33880-4406

Phone

(863) 656-4777

NPI assigned

Nov 29, 2019

Last updated

Nov 29, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Katie L McCann Lee, DDS

Title

Owner/GP

Phone

(863) 656-4777

Specialties & licenses 1

Addresses

Other names 1

• Winter Haven Modern Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexander Lazaro Hernandez, DMD

  • Dentist
  • Winter Haven, FL
  • NPI 1063240588
  NPD

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

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574985600000",
    "number": "1629615497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804406",
            "telephone_number": "863-656-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTER HAVEN MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-29",
        "last_updated": "2019-11-29",
        "status": "A",
        "authorized_official_last_name": "MCCANN LEE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/GP",
        "authorized_official_telephone_number": "863-656-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winter Haven Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Winter Haven Hospital Inc
• Winter Haven Hospital Inc (WH Physician Billing EKG)
• Winter Haven Hospital Inc (Winter Haven Hospital)
• Winter Haven Hospital Inc
• Winter Haven Intensive Care Consultants PLLC
• Winter Haven Nursing LLC (The Palms Nursing and Rehab at Winter Haven)
• Winter Haven Opco LLC (Vivo Healthcare Winter Haven)
• Winter Haven Oral Surgery, PA
• Winter Haven Sebring FL Ophthalmology ASC LLC (Eye Surgery & Laser Center)
• Justin Woei, MD

• Dentist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.