NPIMap

Organization Active NPI

Cedar Pearl Dental, LLC

  • General Practice Dentistry
  • Crestview, FL
National Provider Identifier
1902790348
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CEDAR PEARL DENTAL, LLC
Practice address
222 Cedar Ave
Crestview, FL 32536-2706
Phone
(850) 682-2720
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Dr. Daniel S White, DMDNPI 1528716388
Title
Sole Member
Phone
(316) 323-8745

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

222 Cedar Ave
Crestview, FL 32536-2706

Mailing address

114 Wedgewood CT
Crestview, FL 32536-8405
Phone (316) 323-8745

National Provider Directory

National Provider Directory

Locations

222 Cedar Ave
Crestview, FL 32536
Phone (850) 682-2720

Practitioners & affiliated clinicians

Practitioners 6

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": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1902790348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WEDGEWOOD CT",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325368405",
            "telephone_number": "316-323-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CEDAR AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325362706",
            "telephone_number": "850-682-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR PEARL DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "316-323-8745",
        "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": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.