NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

Doing business as Complete Dentistry of Orange City

  • General Practice Dentistry
  • Orange City, FL
National Provider Identifier
1649765165
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Doing business as
Complete Dentistry of Orange City
Practice address
751 Harley Strickland Blvd
Orange City, FL 32763-7947
Phone
(386) 774-4777
NPI assigned
Jun 27, 2018
Last updated
Jun 27, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Authorized official

Name
Cassandra Petersen
Title
Credentialing Team Lead
Phone
(217) 540-8972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

751 Harley Strickland Blvd
Orange City, FL 32763-7947

Mailing address

751 Harley Strickland Blvd
Orange City, FL 32763-7947
Phone (386) 774-4777

Other names 1

  • Complete Dentistry of Orange City Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionalspa459 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionalspa

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

751 Harley Strickland Blvd
Orange City, FL 32763
Phone (386) 406-9993

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1649765165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 HARLEY STRICKLAND BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637947",
            "telephone_number": "386-774-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 HARLEY STRICKLAND BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637947",
            "telephone_number": "386-774-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Dentistry of Orange City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.