NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals

Doing business as Tomoka Famly Dentistry

  • General Practice Dentistry
  • Ormond Beach, FL
National Provider Identifier
1669793790
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS
Doing business as
Tomoka Famly Dentistry
Practice address
1345 W Granada Blvd Unit 9
Ormond Beach, FL 32174-8191
Phone
(386) 672-8175
Fax
(386) 672-8179
NPI assigned
Jun 11, 2010
Last updated
Jun 11, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Pam Hardiek
Title
Insurance / Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

1345 W Granada Blvd Unit 9
Ormond Beach, FL 32174-8191

Mailing address

1345 W Granada Blvd Unit 9
Ormond Beach, FL 32174-8191
Phone (386) 672-8175

Other names 1

  • Tomoka Famly Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionals PA457 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionals PA

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

1345 W Granada Blvd
Unit 9
Ormond Beach, FL 32174
Phone (386) 672-8175

Practitioners & affiliated clinicians

Practitioners 2

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": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1669793790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 W GRANADA BLVD UNIT 9",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748191",
            "telephone_number": "386-672-8175",
            "fax_number": "386-672-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W GRANADA BLVD UNIT 9",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748191",
            "telephone_number": "386-672-8175",
            "fax_number": "386-672-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "HARDIEK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE / CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "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": "Tomoka Famly Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.