EAST LAKE DENTAL PLLC (NPI# 1518421924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518421924 |
| Entity Type | Organization |
| Organization Name | EAST LAKE DENTAL PLLC |
| Practice Address |
903 N. Narcoossee Rd St. Cloud FL 34771 |
| Mailing Address |
4352 Summer Breeze Way Kissimmee FL 34744-9603 |
| Practice Telephone | 3212361393 |
| Mailing Telephone | 3212361393 |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-01-30 |
| Authorized Official Name | DR. CHACHY REEMA PHILIP (OWNER) |
| Authorized Official Telephone | 4073464873 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| East Lake Family Dental | Doing Business As Name - Organization |
| Street Address |
903 N. NARCOOSSEE RD |
| City | ST. CLOUD |
| State | FL |
| Zip Code | 34771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842667 | Comprehensive Health X5 | Chiropractor | 17410 E Hwy 50, Ste 120, Clermont, FL 34771 | 2020-05-07 |
| 1063073666 | Patricia Mary Krug | Behavior Technician | 5204 Hammock Circe, Saint Cloud, FL 34771 | 2019-06-25 |
| 1245799634 | Divine Transportation Services LLC | Non-emergency Medical Transport (VAN) | 7225 Bridle Path, Saint Cloud, FL 34771 | 2019-03-15 |
| 1811481849 | Unlimited Vision Services | Clinic/Center | 5263 Villa Rose Ave, Saint Cloud, FL 34771 | 2018-06-22 |
| 1962995019 | Joyous Life Inc | Registered Nurse | 2365 Bronco Drive, St Cloud, FL 34771 | 2018-06-13 |
| 1679082895 | Larisa Nadezhda Montano-romero | Behavioral Analyst | 2544 Jenscot Road, Saint Cloud, FL 34771 | 2017-09-20 |
| 1013374842 | Bebalinez Collazo | Counselor | 3221 Anthony Dr, St Cloud, FL 34771 | 2016-01-25 |
| 1588087548 | Dawn Piper Massage | Massage Therapist | 1712 E Irlo Bronson Hwy, St Cloud, FL 34771 | 2014-01-28 |
| 1154668861 | Tania I Marrero | Psychologist | 1441 Lake Parkway Dr, Saint Cloud, FL 34771 | 2013-01-15 |
| 1043562614 | Lourdes Milagros Cartagena-calderon | Speech-Language Pathologist | 5119 Piazza Loop, Saint Cloud, FL 34771 | 2012-10-08 |
| Find all providers in zip 34771 | ||||
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720452436 | Comfortable Care Dental Health Professionals, Pa | Dentist | 2301 Old Canoe Creek Rd, St. Cloud, FL 34772 | 2015-11-18 |
| 1720124209 | Robert Peter Gardetto | Dentist | 1521 Northway Dr, Suite 105, St. Cloud, MN 56303-1223 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326843 | Stellar Smiles Inc. | Dentist | 1501 Corporate Dr Apt 311, Boynton Beach, FL 33426-6600 | 2020-11-07 |
| 1962003269 | Magic Touch Dentistry, P.a. | Dentist | 2 Oakwood Blvd Ste 150a, Hollywood, FL 33020-1960 | 2020-11-03 |
| 1982203584 | Crystel Ananos Riggs Dmd Pa | Dentist | 900 Se Ocean Blvd Ste 248, Stuart, FL 34994-3501 | 2020-10-23 |
| 1053910315 | Dental Buddies of Vero Beach | Dentist | 3755 7th Ter Ste 303, Vero Beach, FL 32960-6547 | 2020-10-19 |
| 1295332013 | Dentists of Nona, Pa | Dentist | 14019 Narcoossee Rd Ste 135, Orlando, FL 32832-7162 | 2020-10-05 |
| 1073110177 | Coral Springs Dental Group, LLC | Dentist | 2029 N University Dr, Coral Springs, FL 33071-6132 | 2020-10-02 |
| 1316554686 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 15800 Orange Blvd, Loxahatchee, FL 33470-3442 | 2020-09-30 |
| 1861009136 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 5068 W State Road 46, Sanford, FL 32771-9246 | 2020-09-30 |
| 1003423922 | Aurora Dental Group, P.a | Dentist | 6176 Sw 8 Street, Miami, FL 33144 | 2020-09-24 |
| 1063029122 | Steven Gross | Dentist | 2021 Ne 210th St, Miami, FL 33179-1629 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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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.