Midway Premier Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MIDWAY PREMIER DENTAL, LLC

Practice address

4169 E State Road 46 Ste 1001
Sanford, FL 32771-8666

Phone

(321) 286-7916

NPI assigned

Jul 22, 2026

Organization subpart

No

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

Authorized official

Name

Robert Gammons

Title

President

Phone

(321) 286-7916

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1770404105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4169 E STATE ROAD 46 STE 1001",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327718666",
            "telephone_number": "321-286-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4169 E STATE ROAD 46 STE 1001",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327718666",
            "telephone_number": "321-286-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY PREMIER DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "GAMMONS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-286-7916"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.