FAMILY ORTHODONTICS (NPI# 1003171703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003171703 |
| Entity Type | Organization |
| Organization Name | FAMILY ORTHODONTICS |
| Practice Address |
12797 Forest Hill Blvd Suite 6a Wellington FL 33414-4763 |
| Practice Telephone | 5617626200 |
| Mailing Telephone | 5617626200 |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |
| Authorized Official Name | DANIEL BASS (ORTHODONTIST) |
| Authorized Official Telephone | 5617626200 |
| Authorized Official Credential | DMD, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DN 18630 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407046428 | Family Orthodontics | Dentist | 57 E Main St Ste 108, Westborough, MA 01581-1445 | 2007-07-26 |
| 1245553072 | Family Orthodontics | Dentist | 1101 Bryan Ave, Suite C, Tustin, CA 92780-4401 | 2010-03-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | FAMILY ORTHODONTICS OF IOWA, PLLC | 1350 Spring Street Nw, Suite 750, Atlanta, GA 30309 |
| New York State Corporations | FAMILY ORTHODONTICS P.C. | 10261 Rte 60, Fredona, Ny 14063 |
| Street Address |
12797 FOREST HILL BLVD SUITE 6A |
| City | WELLINGTON |
| State | FL |
| Zip Code | 33414-4763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144207697 | Lucy Valencia | Family Medicine | 12797 Forest Hill Blvd, Ste B, Wellington, FL 33414-4763 | 2005-12-27 |
| 1144775073 | Krysten Saccocio | Physical Therapist | 12797 Forest Hill Blvd, Suite B, Wellington, FL 33414-4763 | 2016-08-21 |
| 1821336066 | Lucy Valencia | Internal Medicine | 12797 Forest Hill Blvd, Ste B, Wellington, FL 33414-4763 | 2013-01-23 |
| 1538440326 | Dr. Matthew J. Tavolacci Dc, LLC | Chiropractor | 12797 Forest Hill Blvd, Suite B, Wellington, FL 33414-4763 | 2011-09-07 |
| 1558686014 | Matthew John Tavolacci | Chiropractor | 12797 Forest Hill Blvd, Suite B, Wellington, FL 33414-4763 | 2010-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932707247 | Juana Maria Gonzales | Home Health | 2766 Penhall Ct, Wellington, FL 33414 | 2020-10-09 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1730661158 | Michelle Alexis Anagnostu | Nurse Practitioner | 1447 Medical Park Blvd Suite 406, Wellington, FL 33414 | 2018-09-01 |
| 1932686193 | Borola Inc | Occupational Therapy Assistant | 1985 Canterbury Circle, Wellington, FL 33414 | 2018-07-20 |
| 1841783156 | Kid'z World Advance Inc | Behavioral Analyst | 2400 Wrotham Ter, Wellington, FL 33414 | 2018-06-11 |
| 1134619489 | Devin Michael Scheller | Counselor | 2077 Vinings Circle Apt 1303, Wellington, FL 33414 | 2018-05-12 |
| 1942726617 | Amanda Hardy | Social Worker | 11120 South Way, Suite 1, Wellington, FL 33414 | 2017-08-15 |
| 1467976423 | Dawn Carnegia Blackshear | Nurse Practitioner | 1397 Medical Park Blvd Ste 480, Wellington, FL 33414 | 2017-08-01 |
| 1508390238 | Morgan Mccollum | Speech-Language Pathologist | 2158 Polo Gardens Dr Apt 203, Wellington, FL 33414 | 2017-04-19 |
| 1003369786 | Memite G Charlemagne | Registered Nurse | 184 Berenger Walk, Royal Palm Beach, FL 33414 | 2016-07-28 |
| Find all providers in zip 33414 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184827883 | Michael Gardner Thorstad | Dentist | 12765 W Forest Hill Blvd, Wellington Plaza Suite 130, Wellington, FL 33414 | 2007-06-08 |
| 1437209533 | Jonathan S Petrover | Dentist | 2465 S State Road 7, Suite 600, Wellington, FL 33414-9324 | 2007-01-11 |
| 1457444572 | Randall C Shults IIi | Dentist | 1200 Corporate Center Way, Suite 100, Wellington, FL 33414-2108 | 2006-10-02 |
| 1487760856 | David G. Simon | Dentist | 10115 W Forest Hill Blvd, Suite 301, Wellington, FL 33414-3105 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647215 | Matthew Inaba Pickron | Dentist | 6476 Lake Worth Rd, Lake Worth, FL 33463 | 2020-10-21 |
| 1366056848 | Brandon Lee Zipper | Dentist | 901 N Congress Ave Ste 107, Boynton Beach, FL 33426-3316 | 2020-09-02 |
| 1851903298 | Ocoee Dental & Orthodontics, P.a. | Dentist | 2910 Maguire Rd Ste 1005, Ocoee, FL 34761-4742 | 2020-08-18 |
| 1700411857 | Imagine Orthodontic Studio Pllc | Dentist | 3595 S Florida Ave, Lakeland, FL 33803-4860 | 2020-03-10 |
| 1952933541 | Katherine Kapernaros | Dentist | 1395 Center Dr Rm D7-35, Gainesville, FL 32610-3006 | 2020-02-11 |
| 1609408574 | Ortho 99 Plus 1 | Dentist | 7410 Merrill Road, Suite 2, Jacksonville, FL 32277 | 2020-02-10 |
| 1538709514 | Gardner Orthodontics | Dentist | 518 Hollyberry Lane, Suite 105, Orange Park, FL 32065 | 2020-01-08 |
| 1700421344 | Lindsay A Ringdahl Dmd Ms Pa | Dentist | 85 Weston Rd Unit 102, Weston, FL 33326-1158 | 2019-11-07 |
| 1942844493 | Daniel R Camacho | Dentist | 4330 Sheridan St Ste 201a, Hollywood, FL 33021-1406 | 2019-10-28 |
| 1982247102 | Thebis A. Franceschi | Dentist | 813 Delmar Way Apt 116, Delray Beach, FL 33483-3366 | 2019-10-21 |
| Find all providers with the same taxonomy | ||||
| City | WELLINGTON |
| Zip Code | 33414 |
Please comment or provide details below to improve the information on FAMILY ORTHODONTICS.
| 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.