Organization Active NPI

Chain of Lakes Dental PA

  • General Practice Dentistry
  • Windermere, FL
National Provider Identifier
1639719859
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHAIN OF LAKES DENTAL PA
Practice address
1805 Maguire Road
Suite 159
Windermere, FL 34786
Phone
(407) 876-6708
Fax
(407) 217-5921
NPI assigned
Jan 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Authorized official

Name
Vivek Nerikar, DMD
Title
DMD- Dentist Owner
Phone
(904) 553-4859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1805 Maguire Road
Suite 159
Windermere, FL 34786

Mailing address

175 NW 138TH Terrace
Suite 200
Jonesville, FL 32669
Phone (352) 332-3080

National Provider Directory

National Provider Directory

Locations

1805 Maguire Rd
Ste 159
Windermere, FL 34786
Phone (407) 876-6708

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": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1639719859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 NW 138TH TERRACE",
            "address_2": "SUITE 200",
            "city": "JONESVILLE",
            "state": "FL",
            "postal_code": "32669",
            "telephone_number": "352-332-3080",
            "fax_number": "352-333-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 MAGUIRE ROAD",
            "address_2": "SUITE 159",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "34786",
            "telephone_number": "407-876-6708",
            "fax_number": "407-217-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAIN OF LAKES DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "NERIKAR",
        "authorized_official_first_name": "VIVEK",
        "authorized_official_title_or_position": "DMD- DENTIST OWNER",
        "authorized_official_telephone_number": "904-553-4859",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.