PROVIDENCE DENTAL LLC


Address: 12450 E. Colonial Drive Suite 124, Orlando, FL 32826
Phone: 4076350704

PROVIDENCE DENTAL LLC (NPI# 1407330145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407330145
Entity Type Organization
Organization Name PROVIDENCE DENTAL LLC
Practice Address 12450 E. Colonial Drive Suite 124
Orlando
FL 32826
Practice Telephone 4076350704
Practice Fax Number 4072860439
Mailing Telephone 4076350704
Mailing Fax Number 4072860439
Enumeration Date 2018-09-19
Last Update Date 2018-09-19
Authorized Official Name NADIA KAHOOK (CREDENTIALING CONSULTANT)
Authorized Official Telephone 9544465797
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL PENDING 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1295189595 Providence Dental LLC Dentist 225 N Macon St, Macon, GA 31210-6562 2016-04-22

Office Location

Street Address 12450 E. COLONIAL DRIVE SUITE 124
City ORLANDO
State FL
Zip Code 32826

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851908859 Deja Duclos Student in an Organized Health Care Education/Training Program 12201 Research Pakwy, Suite 300, Orlando, FL 32826 2020-09-24
1013404391 Maria Elena Burgett Massage Therapist 1858 N Alafaya Trl Ste 209, Orlando, FL 32826 2018-04-22
1033646112 Shayna Anne Ellery Behavior Technician 2100 N Alafaya Trl Ste 300, Orlando, FL 32826 2017-05-19
1003341769 Samantha Justyn Pharmacist 12612 Challenger Parkway, Suite 365, Orlando, FL 32826 2017-05-01
1083152946 Brenda Garcia Counselor 3157 N. Alafaya Trail, Orlando, FL 32826 2017-02-10
1588106017 Christina Marie Calamis Behavior Technician 2100 N Alafaya Trl, Orlando, FL 32826 2016-11-15
1427406115 Leslie Selina Bennett Behavioral Analyst 13645 E Colonial Dr Apt D390, Orlando, FL 32826 2016-06-02
1003219130 Helen Waller Social Worker 12080 Mendel Dr, Orlando, FL 32826 2014-10-03
1992070783 Erin Jean Pearce Nurse Practitioner 3151 North Alafaya Trail Suite 101, Orlando, FL 32826 2012-03-13
1023380466 Amy Singleton Counselor 12001 Research Pkwy Ste 236, Orlando, FL 32826 2012-02-01
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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851917215 Christian Arcolin Lo Monaco Dentist 8865 Commodity Cir Ste 6, Orlando, FL 32819-9077 2020-06-22
1821625161 Strategic Dental P.a. Dentist 12250 Strategy Blvd Ste 437, Orlando, FL 32817-2108 2020-03-26
1538794185 Nona Dentists 3, Pa Dentist 12964 Narcoossee Rd, Orlando, FL 32832-6925 2020-03-04
1245863463 Leonard S Kaplan Dds Pa Dentist 12131 S Apopka-vineland Rd, Orlando, FL 32836-6802 2020-02-17
1811546856 Leslie Joelle Fernandez Bencosme Dentist 13670 Boggy Creek Rd, Orlando, FL 32824-9203 2019-09-11
1841844321 Ryan Christopher Huhn Dentist 1100 S Orange Ave, Orlando, FL 32806-1249 2019-08-01
1740848167 Quy Phan Dentist 3502 Avalon Park West Blvd, Orlando, FL 32828-7859 2019-05-31
1598232852 Sodo Smiles Dentistry, Pa Dentist 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 2018-10-25
1306332143 Peter Fereg Dentist 5979 Vineland Rd Ste 205, Orlando, FL 32819-7855 2018-07-05
1407342322 Camha P Nguyen Dentist 2619 Greenfield Ave, Orlando, FL 32808 2018-07-03
Find all providers in ORLANDO

Competitor

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City ORLANDO
Zip Code 32826

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Dataset Information

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.

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