Organization Active NPI

Macrodont Solutions Inc

  • General Practice Dentistry
  • Leesburg, FL
National Provider Identifier
1972670586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MACRODONT SOLUTIONS INC
Practice address
1380 W North Blvd
Leesburg, FL 34748-3900
Phone
(352) 326-3368
Fax
(352) 326-3829
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James P Costello, DDS
Title
President
Phone
(352) 408-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1380 W North Blvd
Leesburg, FL 34748-3900

Mailing address

1380 W North Blvd
Leesburg, FL 34748-3900
Phone (352) 326-3368

Other names 1

  • Sunrise Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1380 W North Blvd
Leesburg, FL 34748
Phone (352) 326-3368

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972670586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 W NORTH BLVD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483900",
            "telephone_number": "352-326-3368",
            "fax_number": "352-326-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 W NORTH BLVD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483900",
            "telephone_number": "352-326-3368",
            "fax_number": "352-326-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACRODONT SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-408-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.