MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY P.A. NPI 1124393822

NPI Information

NPI: 1124393822
Provider Name: MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY, P.A.
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
2435 S VOLUSIA AVE STE D2
ORANGE CITY, FL
ZIP 32763
Phone: (386) 775-0833
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MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY, P.A. is a pediatric dentistry dentist in Orange City, FL. The provider is 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. MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF ORANGE CITY, P.A. NPI is 1124393822. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2435 S VOLUSIA AVE STE D2
ORANGE CITY, FL
ZIP 32763-643
Phone: (386) 775-0833

The provider's authorized official is Stephanie Gomez .
The authorized official title is Provider Relations Specialist and has the following contact phone number (305) 274-2499.

The enumeration date for this NPI number is 3/13/2012 and was last updated on 3/26/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	122300000X	Dentist		No
2	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	No
3	1223P0221X	Dentist	Pediatric Dentistry	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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