Central Florida Dental Group, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN16410 Issued in FL

Legal business name

CENTRAL FLORIDA DENTAL GROUP, INC.

Practice address

16215 State Road 50 Ste 102
Clermont, FL 34711-6019

Phone

(407) 654-4024

Fax

(407) 654-4027

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carlos Rodolfo Ortiz, DDS

Title

President

Phone

(407) 654-4024

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311552000000",
    "number": "1801912233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16215 STATE ROAD 50 STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116019",
            "telephone_number": "407-654-4024",
            "fax_number": "407-654-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16215 STATE ROAD 50 STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116019",
            "telephone_number": "407-654-4024",
            "fax_number": "407-654-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA DENTAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-07-25",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "RODOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-654-4024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN16410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Clermont, FL
• Providers in Clermont, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.