NPIMap

Organization Active NPI

Lake Mary Dental PA

  • General Practice Dentistry
  • Lake Mary, FL
National Provider Identifier
1639297732
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN6106 Issued in FL
Legal business name
LAKE MARY DENTAL PA
Practice address
114 Timberlachen Cir
Lake Mary, FL 32746-3395
Phone
(407) 330-3801
Fax
(407) 330-5739
NPI assigned
Mar 27, 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
Dr. Kenneth E Pyle, DDSNPI 1871631846
Title
Dental Director
Phone
(407) 330-3801

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
General Practice Dentistry 1223G0001X DN6106 FL Primary

Addresses

Primary practice location

114 Timberlachen Cir
Lake Mary, FL 32746-3395

Mailing address

114 Timberlachen Cir
Lake Mary, FL 32746-3395
Phone (407) 330-3801

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639297732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 TIMBERLACHEN CIR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463395",
            "telephone_number": "407-330-3801",
            "fax_number": "407-330-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 TIMBERLACHEN CIR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463395",
            "telephone_number": "407-330-3801",
            "fax_number": "407-330-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MARY DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PYLE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTAL DIRECTOR",
        "authorized_official_telephone_number": "407-330-3801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN6106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, 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.