NPIMap

Organization Active NPI

Professional Dental Alliance of FL - Oon, PLLC

Doing business as Aggie Dental Center

  • General Practice Dentistry
  • Cantonment, FL
National Provider Identifier
1891579959
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PROFESSIONAL DENTAL ALLIANCE OF FL - OON, PLLC
Doing business as
Aggie Dental Center
Practice address
2350 S Highway 29
Cantonment, FL 32533-8508
Phone
(850) 968-2106
NPI assigned
Aug 21, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Erica Quinteros
Title
Credentialing
Phone
(724) 901-1964

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

2350 S Highway 29
Cantonment, FL 32533-8508

Mailing address

125 Enterprise Dr Ste 200
Pittsburgh, PA 15275-1223
Phone (249) 011-9647

Other names 1

  • Aggie Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

2350 S Highway 29
Cantonment, FL 32533
Phone (850) 968-2106

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1891579959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223",
            "telephone_number": "249-011-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 S HIGHWAY 29",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325338508",
            "telephone_number": "850-968-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF FL - OON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "QUINTEROS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "724-901-1964"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aggie Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cantonment, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.