NPIMap

Organization Active NPI

Classic Dental, Inc.

  • Dentist
  • Lake Mary, FL
National Provider Identifier
1821259383
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN11075 Issued in FL
Legal business name
CLASSIC DENTAL, INC.
Practice address
4267 W Lake Mary Blvd
Lake Mary, FL 32746-2411
Phone
(407) 302-7774
Fax
(407) 302-5651
NPI assigned
Jun 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Ceasar M. Garcia, D.M.D.NPI 1922017367
Title
Owner
Phone
(407) 302-7774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN11075 FL Primary

Addresses

Primary practice location

4267 W Lake Mary Blvd
Lake Mary, FL 32746-2411

Mailing address

4267 W Lake Mary Blvd
Lake Mary, FL 32746-2411
Phone (407) 302-7774

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1821259383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4267 W LAKE MARY BLVD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462411",
            "telephone_number": "407-302-7774",
            "fax_number": "407-302-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4267 W LAKE MARY BLVD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462411",
            "telephone_number": "407-302-7774",
            "fax_number": "407-302-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "CEASAR",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-302-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.