MEDICAID DENTISTRY OF DAYTONA LLC


Address: 1021 South Ridgewood Ave, Daytona Beach, FL 32114
Phone: 3863042677

MEDICAID DENTISTRY OF DAYTONA LLC (NPI# 1326470436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326470436
Entity Type Organization
Organization Name MEDICAID DENTISTRY OF DAYTONA LLC
Other Organization Name DAYTONA PEDIATRIC DENTISTRY
Practice Address 1021 South Ridgewood Ave
Daytona Beach
FL 32114
Practice Telephone 3863042677
Practice Fax Number 3863041899
Mailing Telephone 3863042677
Mailing Fax Number 3863041899
Enumeration Date 2013-07-31
Last Update Date 2018-05-21
Authorized Official Name MR. MUBASHIR CHAUDHRY (OWNER)
Authorized Official Telephone 3863042677
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 122300000X Dentist FL Dental Providers
N 1223P0221X Dentist
Specialization: Pediatric Dentistry
DN18742 FL Dental Providers
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
DN13783 FL Dental Providers

Other Provider/Organization Names

Other Name Type Code
Daytona Pediatric Dentistry Other Name - Individual/Organization

Office Location

Street Address 1021 SOUTH RIDGEWOOD AVE
City DAYTONA BEACH
State FL
Zip Code 32114

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1376161380 Evolution Health & Performance LLC Physician Assistant 244 S. Palmetto Ave, Daytona Beach, FL 32114 2020-07-07
1407480189 Kierra Imani Kinsey Behavior Technician 1128-a Beville Rd, Daytona Beach, FL 32114 2020-03-02
1043776057 Outreach Community Care Network Inc Pharmacy 240 N. Frederick Avenue, Daytona Beach, FL 32114 2019-02-14
1033681861 Katherine Proppe Specialist/Technologist 1 Aerospace Blvd, Daytona Beach, FL 32114 2018-12-18
1841765047 Anna L Smith Nurse Practitioner 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 2018-10-04
1154806933 Steve Anthony Lee Family Medicine 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 2018-09-27
1285116491 Walgreen Co Durable Medical Equipment & Medical Supplies 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 2018-09-04
1770085656 Merina Lee Occupational Therapist 1159 Australia Ave., Daytona Beach, FL 32114 2018-03-06
1346752755 Hand & Upper Extremity Surgery of Daytona Beach, LLC Non-Pharmacy Dispensing Site 1241 Ridgewood Ave, Daytona Beach, FL 32114 2017-10-26
1104347053 Harry Herman Blanke IIi Family Medicine 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 2017-06-30
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

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.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063649580 Falastin R. Abu-samn Dentist 2570 S Atlantic Ave, Daytona Beach, FL 32118-5523 2009-06-11
1073613600 Charles Robert Brown Dentist 912 S Ridgewood Ave, Suite B, Daytona Beach, FL 32114-5349 2006-09-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1073113296 Pediatric Dental Center of Gardens Inc Dentist 18244 Nw 27th Ave, Miami Gardens, FL 33056-3501 2020-10-27
1205446598 Harp Pediatric Dentistry Dentist 31067 Us Highway 19 N, Palm Harbor, FL 34684-4416 2020-08-03
1043829377 Little Champions Pediatric Dentistry Dentist 1330 Sw 22nd St Ste 406, Miami, FL 33145-2945 2020-07-22
1710595509 Bright Smiles Pediatric Dentistry Nassau LLC Dentist 960135 Gateway Blvd, Fernandina Beach, FL 32034-9120 2020-07-17
1578180097 Juliana Grace Fitzgerald Dentist 7505 Grand Lely Dr Bldg 1, Naples, FL 34113-1753 2020-06-30
1861012569 Toni-marie Small Dentist 12625 76th Rd N, West Palm Beach, FL 33412-2259 2020-04-22
1003446824 Spring Hill Pediatric Dentistry, LLC Dentist 7140 Sagheer St., Brooksville, FL 34613 2020-01-21
1114573086 Kids Dentist LLC Dentist 8058 W Mcnab Rd, North Lauderdale, FL 33068-4254 2019-08-15
1558915157 Dentistry for Children of Florida, Pllc Dentist 3021 Airport Rd N Ste 203, Naples, FL 34105-3077 2019-07-31
1528620937 Catherine Jane Graham Dentist 1395 Center Dr Rm D11-6, Gainesville, FL 32610-3006 2019-07-05
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Competitor

Search similar providers

City DAYTONA BEACH
Zip Code 32114

Improve Information

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Dataset Information

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.

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