CHILDREN AND TEEN DENTAL GROUP OF FLORIDA (NPI# 1982072633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982072633 |
| Entity Type | Organization |
| Organization Name | CHILDREN AND TEEN DENTAL GROUP OF FLORIDA |
| Practice Address |
225 Imperial Blvd Lakeland FL 33803-4612 |
| Mailing Address |
342 N Main St Suite 200 Alpharetta GA 30009-8376 |
| Practice Telephone | 8636444739 |
| Mailing Telephone | 7707444581 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | BRIAN SMITH (CFO) |
| Authorized Official Telephone | 7702315348 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 107 W Robertson St, Brandon, FL 335115111 | 8134403161 | |
| 2015 E Edgewood Dr, Lakeland, FL 338033601 | 8636679000 | |
| 2707 Tampa Rd, Palm Harbor, FL 346843312 | 7277856521 | |
| 3885 S Florida Ave, Lakeland, FL 338131109 | 8636444739 | |
| 5120 Us Highway 19, New Port Richey, FL 346523942 | 7278473113 | |
| 5245 Us Highway 19, New Port Richey, FL 346523967 | 7278473113 | |
| 5456 Spring Hill Dr, Spring Hill, FL 346064559 | 3526661400 | |
| 6606 Forest Ave, New Port Richey, FL 346532611 | 7278492454 | |
| 727 3rd St Sw, Winter Haven, FL 338803419 | 8637978453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720347 | Children and Teen Dental Group of Florida | Dentist | 2707 Tampa Rd, Palm Harbor, FL 34684-3312 | 2018-12-04 |
| Street Address |
225 IMPERIAL BLVD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-4612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538200282 | Nancy Montgomery | Dentist | 225 Imperial Blvd, Lakeland, FL 33803-4612 | 2007-02-08 |
| 1851557078 | Imperial Boulevard Management,llc | Dentist | 225 Imperial Blvd, Lakeland, FL 33803-4612 | 2008-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407344435 | Dentists of Lakeland, Pa | Dentist | 3700 Us Highway 98 N Ste 105, Lakeland, FL 33809-3809 | 2018-04-25 |
| 1235649518 | Lakeland Modern Dentistry, Pa | Dentist | 4620 S Florida Ave Ste 120, Lakeland, FL 33813-2166 | 2017-10-02 |
| 1316497134 | Dental Associates of Florida (s. Lakeland) Pllc | Dentist | 444 W Pipkin Rd, Lakeland, FL 33813-2612 | 2016-10-05 |
| 1023564903 | Georges Raffoul | Dentist | 2744 South Florida Ave, Lakeland, FL 33584 | 2016-08-30 |
| 1295289171 | Kendrah Lynn Harper | Dentist | 600 W Peachtree St, Lakeland, FL 33815-1504 | 2016-08-09 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1144605320 | Austin Jordan Davis | Dentist | 8950 Us Highway 64 Ste 108, Lakeland, TN 38002-4566 | 2015-07-29 |
| 1407105083 | Elena Kan | Dentist | 5644 Vintage View Boulevard, Lakeland, FL 33812 | 2012-08-29 |
| 1174827901 | Affordable Dentures - Lakeland, P.a. | Dentist | 3615 S Florida Ave Ste 1230, Lakeland, FL 33803-4808 | 2011-01-09 |
| 1407164502 | Shannon Holer Kelso | Dentist | 2156 Harden Blvd., Lakeland, FL 33803 | 2010-09-23 |
| Find all providers in LAKELAND | ||||
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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.