Bayside Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

BAYSIDE ENDODONTICS

Practice address

9075- Seminole Blvd.
Seminole, FL 33772

Phone

(727) 576-3636

NPI assigned

May 9, 2023

Last updated

May 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brent Jarred Mayer, DMD

Title

Owner

Phone

(727) 576-3636

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1720778244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9075- SEMINOLE BLVD.",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "33772",
            "telephone_number": "727-576-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075- SEMINOLE BLVD.",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "33772",
            "telephone_number": "727-576-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "JARRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-576-3636",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Seminole, FL
• Providers in Seminole, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.