Altamonte Springs Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ALTAMONTE SPRINGS DENTAL, PLLC

Practice address

499 E Central Pkwy Ste 200
Altamonte Springs, FL 32701-3450

Phone

(407) 831-3959

NPI assigned

Mar 19, 2020

Organization subpart

No

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

Authorized official

Name

Peter Kelly

Title

Owner

Phone

(410) 303-1528

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan W Preble, D.M.D.

  • General Practice Dentistry
  • Altamonte Springs, FL
  • NPI 1932322898
  NPD (past)

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1679109920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 E CENTRAL PKWY STE 200",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327013450",
            "telephone_number": "407-831-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 E CENTRAL PKWY STE 200",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327013450",
            "telephone_number": "407-831-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMONTE SPRINGS DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-303-1528"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN12540",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN19430",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN23428",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@dentalaltamonte.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "499 E Central Pkwy Ste 200",
            "city": "Altamonte Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327013450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Altamonte Oral & Maxillofacial Surgery LLC
• Altamonte Pediatric Associates
• Altamonte Pediatric Associates
• Altamonte Pediatric Associates
• Altamonte Springs Dental Group PA (Altamonte Springs Dental Group)
• Altamonte Springs Diagnostic Imaging Inc (Mid Florida Imaging)
• Altamonte Springs Injury Clinic LLC
• Altamonte Womens Center PA
• Alternative Speech and Swallowing Solutions, Inc
• Altmonte Outpatient Surgery Center, LLC

• Dental Clinic/Center in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.