PROFESSIONAL DENTAL ALLIANCE OF PRT ST LUCIE PRMA VSTA, PLLC (NPI# 1750948907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750948907 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL DENTAL ALLIANCE OF PRT ST LUCIE PRMA VSTA, PLLC |
| Practice Address |
499 Nw Prima Vista Blvd Unit 107 Port St Lucie FL 34983-8786 |
| Mailing Address |
11 S Mill St Ste 200 New Castle PA 16101-3680 |
| Practice Telephone | 7723361500 |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | JESSICA BARRETTE (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 7246982997 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
499 NW PRIMA VISTA BLVD UNIT 107 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34983-8786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053849919 | Kerry D Aston | Dentist | 499 Nw Prima Vista Blvd Unit 107, Port St Lucie, FL 34983-8786 | 2017-05-23 |
| 1750938072 | Professional Dental Alliance of Florida, Pllc | Dentist | 499 Nw Prima Vista Blvd Unit 107, Port St Lucie, FL 34983-8786 | 2019-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588224109 | Skytop Transportation Inc | Non-emergency Medical Transport (VAN) | 6947 Nw Daffodil Ln, Port Saint Lucie, FL 34983 | 2019-06-17 |
| 1063985125 | Ralph Glen Manning | Counselor | 289 Se Sagamore Terrace, Port Saint Lucie, FL 34983 | 2019-01-10 |
| 1275032252 | Charlotte Simpkins | Nurse's Aide | 462 Se Faith Terrace, Port Saint Lucie, FL 34983 | 2018-02-06 |
| 1124547989 | Alicia Maria Herrero Marzo | Case Manager/Care Coordinator | 749 Nw Orchid St, Port St Lucie, FL 34983 | 2017-09-13 |
| 1922535137 | Superior Living 'llc' | Assisted Living Facility | 496 Southeast Verada, Port St Lucie, FL 34983 | 2017-05-18 |
| 1760931562 | Lisa A Joseph | Registered Nurse | 1602 Se Sandia Dr, Psl, FL 34983 | 2016-09-22 |
| 1891146270 | Janet Bayramyan | Counselor | 453 Nw Dover Ct, Port St Lucie, FL 34983 | 2016-06-27 |
| 1033565650 | Jennifer J Ramos | Physician Assistant | 1581 Sw Bayshore Blvd, Port St Lucie, FL 34983 | 2016-05-12 |
| 1659741379 | Amy Mae Dipalma | Physical Therapy Assistant | 5238 Nw Rugby Dr, Port St Lucie, FL 34983 | 2015-10-07 |
| 1942682406 | Vikash Dahya | Dentist | 499 Sw Prima Vista Blvd, Port St. Lucie, FL 34983 | 2015-06-22 |
| Find all providers in zip 34983 | ||||
| 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 |
|---|---|---|---|---|
| 1811482656 | Chi Nguyen | Dentist | 1100 Sw Saint Lucie West Blvd Ste 206, Port St Lucie, FL 34986-1735 | 2018-06-25 |
| 1801304977 | Tradition Dental, P.a. | Dentist | 1973 Sw Savage Blvd Ste 205, Port St Lucie, FL 34953-2791 | 2018-01-11 |
| 1427568195 | Kevin A Jones | Dentist | 1384 Sw Saint Lucie West Blvd, Port St Lucie, FL 34986-2109 | 2017-10-06 |
| 1053849919 | Kerry D Aston | Dentist | 499 Nw Prima Vista Blvd Unit 107, Port St Lucie, FL 34983-8786 | 2017-05-23 |
| 1366975575 | Comfortable Care Dental Health Professionals, Pa | Dentist | 10670 Sw Tradition Pkwy, Port St Lucie, FL 34987-2862 | 2017-04-05 |
| 1548432321 | Ronald Craig Cusato | Dentist | 316 Nw Bethany Dr, Port St Lucie, FL 34986-3578 | 2008-04-01 |
| 1932397536 | Christopher Lawrence Petterson | Dentist | 10157 S Federal Hwy, Port St Lucie, FL 34952-5609 | 2007-10-09 |
| 1043426778 | Brian Marti Kusel | Dentist | 491 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-2044 | 2007-05-16 |
| 1720290455 | Ryan Ellis Askeland | Dentist | 421 Sw Bethany Dr, Port St Lucie, FL 34986-2136 | 2007-05-04 |
| 1851414056 | John S Cairns | Dentist | 1343 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5366 | 2007-04-10 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34983 |
Please comment or provide details below to improve the information on PROFESSIONAL DENTAL ALLIANCE OF PRT ST LUCIE PRMA VSTA, PLLC.
| 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.