VBDC of Lake Park PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VBDC OF LAKE PARK PLLC

Practice address

101 N Congress Ave
Lake Park, FL 33403-3804

Phone

(478) 733-0857

Fax

(478) 254-5709

NPI assigned

Dec 27, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Paul Jason Mann, DMD

Title

Owner

Phone

(478) 733-0857

Specialties & licenses 1

Addresses

Other names 1

• Value Dental Center Doing business as

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545868800000",
    "number": "1861964116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N MACON ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312106562",
            "telephone_number": "478-733-0857",
            "fax_number": "478-254-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N CONGRESS AVE",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334033804",
            "telephone_number": "478-733-0857",
            "fax_number": "478-254-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VBDC OF LAKE PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-733-0857",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Value Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Men T Van, RPH
• Dibanni Vasquez, M.D.
• Victoria ABA Theraphy
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• Allyson Rae Villafane, M.A
• Carlos Vivanco, RBT
• Wal-Mart Stores East LP

• General Practice Dentistry in Lake Park, FL
• Providers in Lake Park, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.