Organization Active NPI

Family Denistry of Daytona Beach, LLC

  • Dental Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1871803817
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN9896 Issued in FL
Legal business name
FAMILY DENISTRY OF DAYTONA BEACH, LLC
Practice address
244 N Frederick Ave
Daytona Beach, FL 32114-3408
Phone
(386) 255-0238
Fax
(386) 255-5566
NPI assigned
Oct 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Authorized official

Name
Robbin J Quarterman, DMDNPI 1962539197
Title
Dentist/Owner
Phone
(386) 255-1799

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
Dental Clinic/Center 261QD0000X DN9896 FL Primary

Addresses

Primary practice location

244 N Frederick Ave
Daytona Beach, FL 32114-3408

Mailing address

244 N Frederick Ave
Daytona Beach, FL 32114-3408
Phone (386) 255-0238

Other identifiers 1

IdentifierTypeStateIssuer
077539896MedicaidFL

National Provider Directory

National Provider Directory

Locations

244 N Frederick Ave
Daytona Beach, FL 32114
Phone (386) 255-0238

Practitioners & affiliated clinicians

Practitioners 1

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": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1871803817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N FREDERICK AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321143408",
            "telephone_number": "386-255-0238",
            "fax_number": "386-255-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N FREDERICK AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321143408",
            "telephone_number": "386-255-0238",
            "fax_number": "386-255-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENISTRY OF DAYTONA BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "QUARTERMAN",
        "authorized_official_first_name": "ROBBIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "386-255-1799",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN9896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077539896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.