NPIMap

Organization Active NPI

Coast Dental P.a.

  • Dentist
  • Winter Springs, FL
National Provider Identifier
1972179273
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COAST DENTAL P.A.
Practice address
5285 Red Bug Lake Rd Ste 105
Winter Springs, FL 32708-4973
Phone
(407) 696-4474
Fax
(407) 696-1001
NPI assigned
May 28, 2021
Organization subpart
Yes
Parent organization
COAST DENTAL P.A.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Melody Rivera
Title
Credentialing Manager
Phone
(813) 350-7166

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 31

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

View all 31

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Coast Dental PA (32 organizations share this tax ID)
Part of
Coast Dental PA

Locations

5285 Red Bug Lake Rd
Ste 105
Winter Springs, FL 32708
Phone (407) 696-4474

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

NPPES NPI Registry

Primary practice location

5285 Red Bug Lake Rd Ste 105
Winter Springs, FL 32708-4973

Mailing address

5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262
Phone (813) 288-1999

Other names 1

NPPES NPI Registry
  • Coast Dental-Tuscawilla Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 28, 2021.

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1972179273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 BENJAMIN CENTER DR STE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345262",
            "telephone_number": "813-288-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 RED BUG LAKE RD STE 105",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327084973",
            "telephone_number": "407-696-4474",
            "fax_number": "407-696-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST DENTAL P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COAST DENTAL P.A.",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "813-350-7166"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Dental-Tuscawilla",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.