Premier Dental Clinic, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN15556 Issued in FL

Legal business name

PREMIER DENTAL CLINIC, P.A.

Practice address

1330 South Orlando Avenue
Winter Park, FL 32789

Phone

(407) 430-2227

NPI assigned

Feb 5, 2016

Organization subpart

No

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

Authorized official

Name

Rosa M. Garcia, D.D.S.

Title

Dentist

Phone

(407) 430-2227

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1669830600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720095",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32872",
            "telephone_number": "407-430-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SOUTH ORLANDO AVENUE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32789",
            "telephone_number": "407-430-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "407-430-2227",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Winter Park, FL
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• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.