NPIMap

Organization Active NPI

Indigo Dental Inc

  • Dental Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1699861336
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN0013454 Issued in FL
Legal business name
INDIGO DENTAL INC
Practice address
139 Executive Cir
Suite 101
Daytona Beach, FL 32114-1198
Phone
(386) 253-3629
Fax
(386) 253-3620
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. David Robert Lloyd, DDSNPI 1912342767
Title
President
Phone
(386) 253-3629

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)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN0013454 FL Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

139 Executive Cir
Suite 101
Daytona Beach, FL 32114-1198

Mailing address

139 Executive Cir
Suite 101
Daytona Beach, FL 32114-1198
Phone (386) 253-3629

Other names 1

  • Indigo Dental of Daytona Beach Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1699861336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 EXECUTIVE CIR",
            "address_2": "SUITE 101",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141198",
            "telephone_number": "386-253-3629",
            "fax_number": "386-253-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 EXECUTIVE CIR",
            "address_2": "SUITE 101",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141198",
            "telephone_number": "386-253-3629",
            "fax_number": "386-253-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-253-3629",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN0013454",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indigo Dental of Daytona Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.