COUNTRYSIDE DENTAL ASSOC INC (NPI# 1699934646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699934646 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE DENTAL ASSOC INC |
| Practice Address |
5810 S. Flamingo Rd Cooper City FL 33330-3237 |
| Practice Telephone | 9544343229 |
| Practice Fax Number | 9546806254 |
| Mailing Telephone | 9544343229 |
| Mailing Fax Number | 9546806254 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2011-01-20 |
| Authorized Official Name | DR. MICHAEL J ANCONA (PRESIDENT/DENTIST) |
| Authorized Official Telephone | 9544343229 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DN8648 | FL | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
DN18066 | FL | Dental Providers |
| N | 122300000X | Dentist | DN18677 | FL | Dental Providers |
| Y | 122300000X | Dentist | DN8648 | Dental Providers |
| Street Address |
5810 S. FLAMINGO RD |
| City | COOPER CITY |
| State | FL |
| Zip Code | 33330-3237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830595 | Community Children's Therapy, Inc | Developmental Therapist | 12353 Natalies Cove Rd, Cooper City, FL 33330 | 2020-10-27 |
| 1508365982 | Sun Coast Recovery Ranch LLC | Substance Abuse Rehabilitation Facility | 4801 Hancock Rd, Southwest Ranches, FL 33330 | 2018-02-12 |
| 1487153441 | Everglades Physicians Alliance LLC | Internal Medicine | 4745 Volunteer Road, Suite 301, Davie, FL 33330 | 2018-02-06 |
| 1639689532 | Tariq Azeez | Occupational Therapy Assistant | 4301 S Flamingo Road #101, Davie, FL 33330 | 2017-10-05 |
| 1497129597 | Right Path Recovery, LLC | Substance Abuse Rehabilitation Facility | 4801 Hancock Road, Southwest Ranches, FL 33330 | 2015-11-30 |
| 1104202878 | Meghan Ashley Oswain | Occupational Therapist | 3141 Sw 118 Terrace, Davie, FL 33330 | 2015-08-05 |
| 1588075089 | Nicole Santiago | Respiratory Therapist, Registered | 5117 Sw 122nd Terrace, Cooper City, FL 33330 | 2014-05-19 |
| 1205180171 | Richard L. Sherman, D.d.s. | Dentist | 4725 Sw 148 Ave. Suite 203, Davie, FL 33330 | 2012-10-31 |
| 1952612996 | Vikram V Thakar | Podiatrist | 11302 Sw 55 St, Cooper City, FL 33330 | 2010-06-24 |
| 1376875344 | Carlos E. Spera, Md, Pa | Clinic/Center | 12575 Orange Drive #303, Davie, FL 33330 | 2010-02-02 |
| Find all providers in zip 33330 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100451 | South Florida Sleep Solutions LLC | Dentist | 9100 Sw 53rd St, Cooper City, FL 33328-5021 | 2020-10-07 |
| 1770001406 | Michael Lee King | Dentist | 5900 Hiatus Rd Ste 300, Cooper City, FL 33330-4527 | 2017-09-01 |
| 1053430751 | Lloyd E. Beaufils | Dentist | 10640 Griffin Road, Ste 101, Cooper City, FL 33328 | 2007-03-27 |
| 1215065339 | Michael J Ancona | Dentist | 5810 S Flamingo Rd, Cooper City, FL 33330-3237 | 2007-03-01 |
| 1558434506 | Sonya D Lewis Dmd Pa | Dentist | 10400 Griffin Rd, Suite #303c, Cooper City, FL 33328-3337 | 2006-11-16 |
| 1538273313 | Jamie Lynne Shore | Dentist | 2665 North Hiatus Road, Cooper City, FL 33026 | 2006-08-18 |
| 1427407626 | Lina Torres | Dentist | 9870 Griffin Rd, Cooper City, FL 33328-3419 | 2016-06-08 |
| 1558747808 | Travel-dent, Birns & Birns, Pa | Dentist | 5121 Sw 90th Ave, Suite 7, Cooper City, FL 33328-3612 | 2015-08-09 |
| 1982032538 | Sage Dental of Davie, Pllc | Dentist | 9870 Griffin Rd, Cooper City, FL 33328-3419 | 2013-10-17 |
| 1386916211 | Seth Andrew Gilson | Dentist | 9870 Griffin Rd, Cooper City, FL 33328-3419 | 2012-02-08 |
| Find all providers in COOPER CITY | ||||
| City | COOPER CITY |
| Zip Code | 33330 |
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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.