NPIMap

Organization Active NPI

Dental Excellence at Fishhawk

  • Dentist
  • Lithia, FL
National Provider Identifier
1952502742
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15191 Issued in FL
Legal business name
DENTAL EXCELLENCE AT FISHHAWK
Practice address
5486 Lithia Pinecrest Rd
Lithia, FL 33547-2853
Phone
(813) 571-5555
Fax
(813) 571-5559
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Richard Michael Kernagis
Title
DMD
Phone
(813) 571-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN15191 FL Primary

Addresses

Primary practice location

5486 Lithia Pinecrest Rd
Lithia, FL 33547-2853

Mailing address

5486 Lithia Pinecrest Rd
Lithia, FL 33547-2853
Phone (813) 571-5555

National Provider Directory

National Provider Directory
Tax ID family
Dental Excellence at Fishhawk3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

5486 Lithia Pinecrest Rd
Lithia, FL 33547
Phone (813) 571-5555

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1952502742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5486 LITHIA PINECREST RD",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335472853",
            "telephone_number": "813-571-5555",
            "fax_number": "813-571-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5486 LITHIA PINECREST RD",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335472853",
            "telephone_number": "813-571-5555",
            "fax_number": "813-571-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL EXCELLENCE AT FISHHAWK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "KERNAGIS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "813-571-5555",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.