Organization Active NPI

Gulf Coast Dental LLC

  • General Practice Dentistry
  • Niceville, FL
National Provider Identifier
1730381344
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 10604 Issued in FL
Legal business name
GULF COAST DENTAL LLC
Practice address
4566 Hwy 20E
Suite 108
Niceville, FL 32578
Phone
(850) 897-9600
Fax
(850) 678-8683
NPI assigned
Jun 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Steven G RobinetteNPI 1508067927
Title
Dentist Owner
Phone
(850) 897-9600

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 10604 FL Primary

Addresses

Primary practice location

4566 Hwy 20E
Suite 108
Niceville, FL 32578

Mailing address

4566 Hwy 20E
Suite 108
Niceville, FL 32578
Phone (850) 897-9600

National Provider Directory

National Provider Directory

Locations

4566 E Highway 20
Ste 108
Niceville, FL 32578
Phone (850) 897-9600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730381344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 HWY 20E",
            "address_2": "SUITE 108",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-897-9600",
            "fax_number": "850-678-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 HWY 20E",
            "address_2": "SUITE 108",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-897-9600",
            "fax_number": "850-678-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBINETTE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "850-897-9600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 10604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.