Pediatric Dental Center

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN6377 Issued in FL

Legal business name

PEDIATRIC DENTAL CENTER

Practice address

517 Corner Drive
Brandon, FL 33511-5718

Phone

(813) 685-0804

Fax

(813) 681-7213

NPI assigned

Apr 16, 2012

Organization subpart

No

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

Authorized official

Name

Dr. William Edward Gonzalez, D.M.D.NPI 1003930579

Title

President

Phone

(813) 685-0804

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• William Edward Gonzalez, DMD

  • Pediatric Dentistry
  • Brandon, FL
  • NPI 1003930579
  NPD (past) Authorized official
• Lyda Maria Lopez, DDS

  • Pediatric Dentistry
  • Brandon, FL
  • NPI 1285060905
  NPD (past)

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1710244702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 CORNER DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115718",
            "telephone_number": "813-685-0804",
            "fax_number": "813-681-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 CORNER DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115718",
            "telephone_number": "813-685-0804",
            "fax_number": "813-681-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-685-0804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN6377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074133700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Raye Smith Pearson, DO
• Patricia Loretta Pearson
• Deanna Pecina
• Pediatria Healthcare, LLC
• Pediatric Associates of Tampa Bay, LLC
• Pediatric Dentistry of Brandon PA
• Pediatric Health Care Alliance, PA
• Pediatric Therapy Services, Inc.
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc

• Pediatric Dentistry in Brandon, FL
• Providers in Brandon, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.