EMERALD COAST PERIODONTICS (NPI# 1306223888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306223888 |
| Entity Type | Organization |
| Organization Name | EMERALD COAST PERIODONTICS |
| Practice Address |
719 Bayshore Drive Niceville FL 32578 |
| Practice Telephone | 8506786485 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |
| Authorized Official Name | MARTIN M WOOLSEY (PERIODONTIST) |
| Authorized Official Telephone | 8506786485 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN21004 | FL | Dental Providers |
| Street Address |
719 BAYSHORE DRIVE |
| City | NICEVILLE |
| State | FL |
| Zip Code | 32578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028563 | Southern Breeze Healthcare | Family Medicine | 4556 E Hwy 20, Suite 105, Niceville, FL 32578 | 2018-10-03 |
| 1497252860 | Molly Marie Everitt | Physician Assistant | 2190 Fl-85 N, Niceville, FL 32578 | 2018-04-11 |
| 1972009314 | Alexis Aust | Student in an Organized Health Care Education/Training Program | 104 Arrowhead Way, Niceville, FL 32578 | 2018-04-04 |
| 1518488949 | Michelle Sasala | Nurse Practitioner | 4550 E Highway 20, Niceville, FL 32578 | 2017-07-06 |
| 1003336199 | Comfortable Care Denta Health Professionals, Pa | Dentist | 1386 E John Sims Parkway, Niceville, FL 32578 | 2017-06-21 |
| 1538586136 | Pamela Ottesen Dmd LLC | Dentist | 1536 John Sims Pkwy, Niceville, FL 32578 | 2014-03-21 |
| 1417204066 | Mary Jo Stiles | Hearing Instrument Specialist | 4400 Hwy, 20 East, Suite # 211, Niceville, FL 32578 | 2012-08-13 |
| 1093086563 | Pat T. Tidwell Md Pa | Clinic/Center | 4554 Highway 20 East, Niceville, FL 32578 | 2012-01-16 |
| 1952683260 | Gentle Birth Options, LLC | Nurse Practitioner | 296 Bayshore Drive, Niceville, FL 32578 | 2011-09-13 |
| 1326326869 | Alternative Living, Inc. | Assisted Living Facility | 1053 John Sims Parkway, Niceville, FL 32578 | 2011-08-02 |
| Find all providers in zip 32578 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356365035 | Doron Bresler | Dentist | 719 Bayshore Dr, Niceville, FL 32578-2527 | 2006-07-27 |
| 1871731794 | Patricia R Francisco | Dentist | 719 Bayshore Dr, Niceville, FL 32578-2527 | 2009-01-30 |
| 1316185275 | Dennis B Davis | Dentist | 719 Bayshore Dr, Niceville, FL 32578-2527 | 2009-01-30 |
| 1437201712 | Emerald Coast Periodontics, P.a. | Dentist | 719 Bayshore Dr, Niceville, FL 32578-2546 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344354 | Philipkjosephsllc | Dentist | 161 Monterey Bay Dr, Boynton Beach, FL 33426-8438 | 2020-10-21 |
| 1194322651 | Peter Tsambazis Dmd, Inc | Dentist | 6654 Collier Blvd Unit 104, Naples, FL 34114-8179 | 2020-10-07 |
| 1265041578 | Lauren Elise Steinberg | Dentist | 7301 W Palmetto Park Rd Ste 303a, Boca Raton, FL 33433-3458 | 2020-07-23 |
| 1306462213 | Miami Healthy Smiles | Dentist | 8861 Sw 69th Ct, Pinecrest, FL 33156-1605 | 2020-06-17 |
| 1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
| 1437785847 | Modern Dental Cape Coral Pllc | Dentist | 706 Sw Pine Island Rd, Suite 103, Cape Coral, FL 33991 | 2020-03-17 |
| 1437783792 | Anthony Joseph Michelotti | Dentist | 3331 Briarwood Cir, Safety Harbor, FL 34695-4691 | 2020-02-26 |
| 1417595893 | Park Plaza Dental Care | Dentist | 1144 N Federal Hwy, Pompano Beach, FL 33062-4322 | 2019-12-16 |
| 1619538832 | George Edward Tolson V | Dentist | 1739 E Commercial Blvd, Oakland Park, FL 33334-5737 | 2019-06-27 |
| 1396203485 | Michael Steven Liss | Dentist | 2600 N Military Trl Ste 310, Boca Raton, FL 33431-6315 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EMERALD COAST PERIODONTICS.
| 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.