BOULEVARD CENTER FOR ADVANCED DENTISTRY (NPI# 1275906232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275906232 |
| Entity Type | Organization |
| Organization Name | BOULEVARD CENTER FOR ADVANCED DENTISTRY |
| Practice Address |
1343 Se Port St Lucie Blvd Port St Lucie FL 34952-5366 |
| Practice Telephone | 7723371111 |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |
| Authorized Official Name | DR. JEROME VITALE (DENTIST/OWNER) |
| Authorized Official Telephone | 7723371111 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DN13975 | FL | Ambulatory Health Care Facilities |
| Street Address |
1343 SE PORT ST LUCIE BLVD |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952-5366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851414056 | John S Cairns | Dentist | 1343 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5366 | 2007-04-10 |
| 1497946982 | Julie A Cromer | Dentist | 1343 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5366 | 2007-08-08 |
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|---|---|---|---|---|
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| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952832313 | Tdc Port St.lucie LLC | Clinic/Center | 1385 Sw Gatlin Blvd, Port St Lucie, FL 34953-4102 | 2017-03-27 |
| 1154759041 | Florida Family Dental LLC | Clinic/Center | 10624 S Federal Hwy, Port St Lucie, FL 34952-6401 | 2013-10-31 |
| 1699032490 | David J. Krynauw, Dds, Pa | Clinic/Center | 1761 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5479 | 2012-04-18 |
| 1174183719 | Jaisanvi Pa | Clinic/Center | 308 Nw Bethany Dr, Port St Lucie, FL 34986-3578 | 2019-06-17 |
| 1699256792 | Stephen G. Blank, Dds, Pa | Clinic/Center | 184 Nw Central Park Plz, Port St Lucie, FL 34986-2451 | 2018-08-27 |
| 1942669924 | Stranigan, Askeland & Harris Dmds Pa | Clinic/Center | 421 Sw Bethany Dr, Port St Lucie, FL 34986-2136 | 2016-02-18 |
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| 1811598238 | Dental Plus Management, LLC | Clinic/Center | 16 Ne 2nd Ave, Deerfield Beach, FL 33441-3504 | 2020-11-03 |
| 1750981452 | Smillie Dental Pllc | Clinic/Center | 5537 S Williamson Blvd Ste 675, Port Orange, FL 32128-8314 | 2020-10-30 |
| 1609476027 | R & R Dentistry Pa | Clinic/Center | 6290 Linton Blvd Unit 202, Delray Beach, FL 33484-6409 | 2020-10-26 |
| 1295334126 | Friedman Dental Group Miami, Pllc | Clinic/Center | 1717 N Bayshore Dr Ste 219, Miami, FL 33132-1196 | 2020-10-21 |
| 1376142547 | Trm Global Enterprise,llc. | Clinic/Center | 145 Crawl Key Ct, Deland, FL 32720-3951 | 2020-10-20 |
| 1568060762 | Bawany LLC | Clinic/Center | 15130 Springview St, Tampa, FL 33624-2332 | 2020-10-12 |
| 1992312730 | Rocent Dental Care, Inc. | Clinic/Center | 1 Sw 129th Ave Ste 406, Pembroke Pines, FL 33027-1718 | 2020-09-25 |
| 1730795857 | Kind Smiles Dental Health | Clinic/Center | 11155 State Road 70 E, Lakewood Ranch, FL 34202 | 2020-09-23 |
| 1952916306 | Simmons Services LLC | Clinic/Center | 2500 Sw 107th Ave Ste 45, Miami, FL 33165-2492 | 2020-09-12 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
Please comment or provide details below to improve the information on BOULEVARD CENTER FOR ADVANCED DENTISTRY.
| 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.