FL Specialty Dental Services, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

FL SPECIALTY DENTAL SERVICES, PLLC

Practice address

2808 Enterprise Rd
Debary, FL 32713-2753

Phone

(386) 668-7776

NPI assigned

May 29, 2024

Organization subpart

Yes

Parent organization

FL SPECIALTY DENTAL SERVICES, PLLCAs reported in NPPES

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

Authorized official

Name

Charlotte Dasch

Title

Direc of Cred and Prov Rel

Phone

(504) 638-0303

Specialties & licenses 1

Addresses

Other names 1

• Timothy A. Glomb DMD PA Doing business as

Tax ID family

FL Specialty Dental Services PLLC2 organizations share this tax ID, including this one

Part of

FL Specialty Dental Services PLLC

Other organizations with this tax ID 1

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

• FL Specialty Dental Services, PLLC

  • Pediatric Dentistry
  • Debary, FL
  • NPI 1811682628
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• FL Specialty Dental Services, PLLC

  • Pediatric Dentistry
  • Debary, FL
  • NPI 1811682628
  NPPES parent name

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1871333690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 ENTERPRISE RD",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132753",
            "telephone_number": "386-668-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FL SPECIALTY DENTAL SERVICES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FL SPECIALTY DENTAL SERVICES, PLLC",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "DIREC OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timothy A. Glomb DMD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ameira M Fargally
• Chanteria Timesha Fears
• Ana Iris Figueroa, PAC
• First Assist Professionals, LLC
• FL Specialty Dental Services, PLLC
• Martha Denise Florez, LMHC
• Florida HH Services LLC
• Florida Injury Medical Centers
• Florida Physical Therapy Services of Orange City, LLC
• Sandra L Fournier, MA LMFT

• Pediatric Dentistry in Debary, FL
• Providers in Debary, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.