NPIMap

Organization Active NPI

Imagine Orthodontic Studio

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pinellas Park, FL
National Provider Identifier
1841942489
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
IMAGINE ORTHODONTIC STUDIO
Practice address
7348 US Highway 19 N
Pinellas Park, FL 33781-4600
Phone
(727) 865-5711
NPI assigned
Jan 25, 2022
Organization subpart
Yes
Parent organization
000000As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Mariella Carreno
Title
Office Manager
Phone
(863) 462-4463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

7348 US Highway 19 N
Pinellas Park, FL 33781-4600

Mailing address

11502 N 56TH St
Temple Terrace, FL 33617-2239
Phone (813) 212-1313

Other names 1

  • Imagine St. Pete Other name

National Provider Directory

National Provider Directory
Tax ID family
Imagine Orthodontic Studio PLLC5 organizations share this tax ID, including this one
Part of
Imagine Orthodontic Studio PLLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7348 US Highway 19 N
Pinellas Park, FL 33781
Phone (727) 865-5711

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1841942489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11502 N 56TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172239",
            "telephone_number": "813-212-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7348 US HIGHWAY 19 N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814600",
            "telephone_number": "727-865-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE ORTHODONTIC STUDIO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "000000",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "CARRENO",
        "authorized_official_first_name": "MARIELLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "863-462-4463"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine St. Pete",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.