D & G Dental Services PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17518 Issued in FL

Legal business name

D & G DENTAL SERVICES PA

Practice address

13171 Cortez Blvd
Brooksville, FL 34613

Phone

(352) 296-1800

NPI assigned

Apr 24, 2009

Organization subpart

No

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

Authorized official

Name

Cristina Dominquez, DMD

Title

Owner

Phone

(352) 296-1800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1750525465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13220",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13171 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "34613",
            "telephone_number": "352-296-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D & G DENTAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "DOMINQUEZ",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-296-1800",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Brooksville, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; 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.