NPIMap

Organization Active NPI

Pace-FL Dental, PA

  • General Practice Dentistry
  • Milton, FL
National Provider Identifier
1750779963
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16315 Issued in FL
Legal business name
PACE-FL DENTAL, PA
Practice address
4873 Highway 90 Ste a
Milton, FL 32571-1401
Phone
(315) 454-6000
NPI assigned
Dec 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Mika L. Weiss
Title
Provider Relations
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN16315 FL Primary

Addresses

Primary practice location

4873 Highway 90 Ste a
Milton, FL 32571-1401

Mailing address

4873 Highway 90 Ste a
Milton, FL 32571-1401

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1750779963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4873 HIGHWAY 90 STE A",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325711401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4873 HIGHWAY 90 STE A",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325711401",
            "telephone_number": "315-454-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE-FL DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "MIKA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.