Forest Park Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FOREST PARK DENTAL PLLC

Practice address

2620 Jenks Ave
Panama City, FL 32405-4311

Phone

(850) 785-8586

NPI assigned

Jun 29, 2017

Organization subpart

No

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

Authorized official

Name

Susan Stewart

Title

Administrator

Phone

(334) 676-2320

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1922529916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 ZELDA CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062607",
            "telephone_number": "334-676-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054311",
            "telephone_number": "850-785-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST PARK DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-676-2320"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raven Lynn Folmar
• Denise Folsom, MS
• Maria Fonseca
• Curtis Foote
• Hannah Fordred, PA
• Forest Park Medical Associates
• Forest Park Smiles on 11TH, PLLC
• Forget-Me-Not Dementia Clinic and Other Neurology Services LLC
• Anna Alise Forgue
• Tiffany Diane Forrester, M.D.

• General Practice Dentistry in Panama City, FL
• Providers in Panama City, 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 Jun 29, 2017; 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.