Mary Teresa Gunning Prendiville, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20902 Issued in FL

Practice address

1495 E Main St
Bartow, FL 33830-5202

Phone

(863) 533-0324

NPI assigned

Sep 7, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prendiville DDS PLLC

  • Dental Clinic/Center
  • Bartow, FL
  • NPI 1629874565
  NPD
• Linda J May DDS PA

  • General Practice Dentistry
  • Bartow, FL
  • NPI 1992890594
  NPD (past)

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1992086771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 PLANTATION CIR APT 305",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335661508",
            "telephone_number": "305-972-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 E MAIN ST",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338305202",
            "telephone_number": "863-533-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDIVILLE",
        "first_name": "MARY TERESA",
        "middle_name": "GUNNING",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kandyce Powell
• Premier Health & Wellness Center of Central Florida LLC
• Premier Women'S Care OB/GYN PLLC
• Phimagham Sriramulu Premkanth, M.D.
• Prendiville DDS PLLC
• Chad Price
• Joshua C Price, LPN
• Progressive Orthodontics, PLLC
• Publix Super Markets Inc
• Roger Henry Pulley, PHARMD

• General Practice Dentistry in Bartow, FL
• Providers in Bartow, 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 Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.