DR. RODERICK M MACINTYRE III (NPI# 1770597411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770597411 |
| Entity Type | Individual |
| Full Name | DR. RODERICK M MACINTYRE III |
| Credential | D.M.D.; M.S. |
| Practice Address |
912 S Ridgewood Ave Suite C Daytona Beach FL 32114-5349 |
| Practice Telephone | 3862520858 |
| Practice Fax Number | 3862537004 |
| Mailing Telephone | 3862520858 |
| Mailing Fax Number | 3862537004 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DN12743 | FL | Dental Providers |
| Street Address |
912 S RIDGEWOOD AVE SUITE C |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-5349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386658284 | East Coast Endodontics | Clinic/Center | 912 S Ridgewood Ave, Suite C, Daytona Beach, FL 32114-5349 | 2006-07-28 |
| 1346679610 | Coastal Spine and Sport of Daytona Beach | Clinic/Center | 912 S Ridgewood Ave, Ste. D, Daytona Beach, FL 32114-5349 | 2013-11-06 |
| 1073613600 | Charles Robert Brown | Dentist | 912 S Ridgewood Ave, Suite B, Daytona Beach, FL 32114-5349 | 2006-09-24 |
| 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 |
| Find all providers in zip 32114 | ||||
| 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 |
|---|---|---|---|---|
| 1013319771 | Volusia Endodontics East, Pa | Dentist | 1148 Pelican Bay Dr, Daytona Beach, FL 32119-1381 | 2014-09-24 |
| 1619137171 | Jeffrey Ben Rosenberg | Dentist | 1517 Mason Ave, Daytona Beach, FL 32117-4548 | 2008-06-09 |
| 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 | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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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.