Douglas Dentistry P a

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DOUGLAS DENTISTRY P A

Practice address

1821 Wellness LN BLDG 3
Trinity, FL 34655-5359

Phone

(727) 372-3200

NPI assigned

Apr 3, 2019

Organization subpart

Yes

Parent organization

DOUGLAS DENTISTRY P AAs reported in NPPES

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

Authorized official

Name

Shawn Douglas, DDSNPI 1790990299

Title

President

Phone

(727) 372-3200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Douglas Dentistry P a

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn James Douglas, DDS, MHA

  • General Practice Dentistry
  • Trinity, FL
  • NPI 1790990299

  Durable Medical Equipment & Medical Supplies

  NPD Authorized official
• Keith Wolfenden, DMD

  • Dentist
  • Berthoud, CO
  • NPI 1629382981
  NPD (past)

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1801358395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 WELLNESS LN BLDG 3",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555359",
            "telephone_number": "727-372-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WELLNESS LN BLDG 3",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555359",
            "telephone_number": "727-372-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS DENTISTRY P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOUGLAS DENTISTRY  P A",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-372-3200",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doctor Bird Transportation LLC (Doctor Bird Transportation)
• Donna L Donati-Waddell, PSY.D.
• James Patrick Donovan, M.D.
• Cameron Dornon, P.T.A.
• Gerard Dorta Torres
• Shawn James Douglas, DDS, MHA
• Sheilah M Drevon, M.D.
• Michale Drew, APRN
• Justin Lee Drobisch, AA
• Kimberley Kay Drury, ARNP

• Durable Medical Equipment & Medical Supplies in Trinity, FL
• Providers in Trinity, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.