CLERMONT ENDODONTIC SPECIALIST, PA (NPI# 1649668682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649668682 |
| Entity Type | Organization |
| Organization Name | CLERMONT ENDODONTIC SPECIALIST, PA |
| Other Organization Name | LAKELAND ENDODONTICS |
| Practice Address |
3207 S Florida Ave Lakeland FL 33803-4550 |
| Practice Telephone | 8639379181 |
| Mailing Telephone | 8639379181 |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |
| Authorized Official Name | KENDRA WALKER (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175408312 |
| Is Organization Subpart | Y |
| Parent Organization Name | CLERMONT ENDODONTIC SPECIALIST, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DN19410 | FL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Lakeland Endodontics | Doing Business As Name - Organization |
| Street Address |
3207 S FLORIDA AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-4550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366085896 | Mdd Dental, Inc | Clinic/Center | 3207 S Florida Ave, Lakeland, FL 33803-4550 | 2019-10-28 |
| 1891342127 | Nicholas Hoepfner | Dentist | 3207 S Florida Ave, Lakeland, FL 33803 | 2019-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942514807 | Advanced Endodontic Specialists LLC | Dentist | 3003 S Florida Ave, #101, Lakeland, FL 33803-4050 | 2010-08-03 |
| 1528246501 | Haider A Alzubaidi | Dentist | 3003 S Florida Ave, Ste 101, Lakeland, FL 33803-4050 | 2008-02-01 |
| 1578695771 | John Henry Galberry | Dentist | 3003 S Florida Ave, Suite 101, Lakeland, FL 33803-4050 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608736 | Mid-florida Endodontics - Winter Garden Pa | Dentist | 15815 Shaddock Drive, Unit-3, Winter Garden, FL 34787 | 2020-10-30 |
| 1154935799 | Orbit Dental Management Pa | Dentist | 1453 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-1968 | 2020-09-01 |
| 1790397370 | Bruce D. Schulman, Dds Pa | Dentist | 10150 Hagen Ranch Rd Ste 200, Boynton Beach, FL 33437-3776 | 2020-08-17 |
| 1770117525 | Volusia Endodontics Pa | Dentist | 2751 Enterprise Rd Ste 211, Orange City, FL 32763-8262 | 2020-03-02 |
| 1417587130 | Advanced Endodontics of Winter Park, Pa | Dentist | 400 W Morse Blvd Ste 102, Winter Park, FL 32789-4259 | 2020-01-22 |
| 1699326603 | North Central Florida Endodontics,pllc | Dentist | 48 Se 16th Ave, Ocala, FL 34471-2521 | 2019-09-23 |
| 1396395919 | Stephen L. Goldfaden, Dds,pa | Dentist | 1905 Nw 13th St Ste 2, Gainesville, FL 32609-3414 | 2019-09-16 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1437707197 | John Zachary Reynolds | Dentist | 3180 Redeemer Way, New Port Richey, FL 34655-4245 | 2019-08-27 |
| 1497307987 | Bradley Sleeth | Dentist | 942 Goldridge Ct, Orange Park, FL 32065-6259 | 2019-07-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CLERMONT ENDODONTIC SPECIALIST, PA.
| 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.