Active NPI
Ma Dental
- General Practice Dentistry
- Lynn Haven, FL
National Provider Identifier
1669958740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- MA DENTAL
- Practice address
- 530 Florida Avenue
Lynn Haven, FL 32444-1736 - Phone
- (850) 271-2341
- Fax
- (850) 271-0679
- NPI assigned
- Jul 12, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael Scott Grandy, DMD
- Title
- Dentist/Owner
- Phone
- (850) 271-2341
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary | ||
| Periodontics | 1223P0300X |
Addresses
Primary practice location
530 Florida Avenue
Lynn Haven, FL 32444-1736
Mailing address
530 Florida Avenue
Lynn Haven, FL 32444-1736
Phone (850) 271-2341
Other names 1
- Bay Smile Docs
National Provider Directory
National Provider DirectoryLocations
530 Florida Ave
Lynn Haven, FL 32444
Phone (850) 271-2341
Practitioners & affiliated clinicians
Practitioners 4
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": "1531353600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531353600000",
"number": "1669958740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 FLORIDA AVENUE",
"city": "LYNN HAVEN",
"state": "FL",
"postal_code": "324441736",
"telephone_number": "850-271-2341",
"fax_number": "850-271-0679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 FLORIDA AVENUE",
"city": "LYNN HAVEN",
"state": "FL",
"postal_code": "324441736",
"telephone_number": "850-271-2341",
"fax_number": "850-271-0679"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MA DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A",
"authorized_official_last_name": "GRANDY",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "850-271-2341",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Bay Smile Docs",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lynn Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.