PEDIATRIC DENTAL GROUP, LLC (NPI# 1235697707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235697707 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL GROUP, LLC |
| Practice Address |
12601 Narcoossee Rd Unite 100a Orlando FL 32832 |
| Mailing Address |
9161 Narcoossee Rd Ste 101b Orlando FL 32827 |
| Practice Telephone | 4077377767 |
| Practice Fax Number | 4077370769 |
| Mailing Telephone | 4077377767 |
| Mailing Fax Number | 4077370769 |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |
| Authorized Official Name | OLUBISI ALNA (CO-OWNER) |
| Authorized Official Telephone | 4077377767 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609018548 | Pediatric Dental Group, LLC | Dentist | 1421 E 13th St, Tulsa, OK 74120-5207 | 2009-03-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | PEDIATRIC DENTAL GROUP, LLC | 602 S Utica, Tulsa, OK 74104 |
| Street Address |
12601 NARCOOSSEE RD UNITE 100A |
| City | ORLANDO |
| State | FL |
| Zip Code | 32832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482728 | Maria Belen Bengolea | Behavior Technician | 10920 Moss Park Rd. Suite 130, Orlando, FL 32832 | 2020-09-23 |
| 1942819495 | Oasis Counseling Services | Community/Behavioral Health | 11954 Narcoossee Rd., Ste 2 #278, Orlando, FL 32832 | 2020-07-29 |
| 1538628219 | Lake Nona Endodontics Pa | Dentist | 13571 Narcoossee Road, Orlando, FL 32832 | 2019-03-13 |
| 1518451343 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 13072 Narcoossee Rd, Orlando, FL 32832 | 2018-06-15 |
| 1356834345 | Cachae Cierra Mason | Clinic/Center | 9412 Randal Park Blvd, Unit 6127, Orlando, FL 32832 | 2018-06-13 |
| 1598258832 | Magda Liliana Sanchez | Behavior Technician | 14046 Millington St, Orlando, FL 32832 | 2018-06-12 |
| 1982106423 | Grace-ann Lewis | Behavior Technician | 10920 Moss Park Road Suite 100, Orlando, FL 32832 | 2018-03-01 |
| 1427574151 | Nona Dentists, Pa | Dentist | 12711 Narcoossee Rd, Building B, Suite 100, Lake Nona, Orlando, FL 32832 | 2017-08-15 |
| 1578084281 | Crispus Nyambariga Ombui | Nurse Anesthetist, Certified Registered | 9452 Randal Park Blvd, Unit 2-2126, Orlando, FL 32832 | 2017-07-03 |
| 1124567086 | Nilda Rivera | Counselor | 10200 Dwell Nona Place, Apt 109, Orlando, FL 32832 | 2017-02-13 |
| Find all providers in zip 32832 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447726922 | A&m Dental Group LLC | Dentist | 8255 Lee Vista Blvd Ste F-g, Orlando, FL 32829-8018 | 2018-10-22 |
| 1295152312 | Hany S Azer | Dentist | 9161 Narcoossee Rd Ste 101b, Orlando, FL 32827 | 2014-03-26 |
| 1952664633 | Michael P. Dimauro D.d.s., P.a. | Dentist | 7424 Docs Grove Cir, Orlando, FL 32819-8010 | 2012-06-19 |
| 1427255694 | Olubisi O Aina | Dentist | 9161 Narcoossee Rd, Suite 101b, Orlando, FL 32827 | 2007-06-29 |
| 1285842658 | Serese Cannon Brooks | Dentist | 12711 Narcoossee Rd Ste 100, Orlando, FL 32832-6991 | 2007-05-18 |
| 1801915541 | David Lester Goldstein | Dentist | 7651 Ashey Park Court C, Suite 410, Orlando, FL 32835-6114 | 2007-03-27 |
| 1124143128 | Kristin M Foley | Dentist | 1549 S Alafaya Trl Ste 200, Orlando, FL 32828-8962 | 2007-03-20 |
| 1851439293 | Charles Morrison Robbins | Dentist | 508 N Mills, Suite B, Orlando, FL 32803 | 2007-02-01 |
| 1982785747 | Mubashir A Chaudhry Dmd Pllc | Dentist | 907 Outer Rd, Orlando, FL 32814-6653 | 2006-10-18 |
| 1275542110 | The New Pediatric Dental Care of Greater Orlando, Inc | Dentist | 11309 Lake Underhill Rd, Suite 103, Orlando, FL 32825-4427 | 2006-08-07 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.