DR. EDWARD LEE STAUDT (NPI# 1992807960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992807960 |
Entity Type | Individual |
Full Name | DR. EDWARD LEE STAUDT |
Credential | DDS |
Practice Address |
944 Bridgewater Dr 2b Ft Orange FL 32129 |
Practice Telephone | 3867568953 |
Mailing Telephone | 3867568953 |
Enumeration Date | 2006-09-01 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
DN0009915 | FL | Dental Providers |
Street Address |
944 BRIDGEWATER DR 2B |
City | FT ORANGE |
State | FL |
Zip Code | 32129 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
Find all providers in zip 32129 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
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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.