LEGACY DENTAL (NPI# 1861796229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861796229 |
| Entity Type | Organization |
| Organization Name | LEGACY DENTAL |
| Practice Address |
4993 W Atlantic Ave Delray Beach FL 33445-3850 |
| Practice Telephone | 5613813100 |
| Practice Fax Number | 5613813323 |
| Mailing Telephone | 5613813100 |
| Mailing Fax Number | 5613813323 |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |
| Authorized Official Name | MR. CHRIS WITTUSEN (DIRECTOR) |
| Authorized Official Telephone | 5613813100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | FL | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518209659 | Legacy Dental | Dentist | 1345 E 3900 S Ste 116, Salt Lake City, UT 84124-4407 | 2013-03-26 |
| 1841204609 | Legacy Dental | Dentist | 1685 Pancheri Dr, Idaho Falls, ID 83402-3169 | 2006-07-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Ohio Business Entities | LEGACY DENTAL CARE - JASON WARN, DDS, LLC | 2150 Milton Road, #210, University Heights, OH 44118 |
| Virginia Business Entities | Legacy Dental LLC | 305 W Fayette St Ste 1613, Baltimore, Maryland 21201 |
| Colorado Business Entities | Legacy Dental Studio LLC | 7900 W. 44th Ave #a, Wheat Ridge, CO 80033 |
| Iowa Business Entities | LEGACY DENTAL, P.C. | 4409 Sw 9th Street, Des Moines, IA 50315 |
| Colorado Business Entities | Legacy Dental, P.C. | 5140 W. 120th Avenue, Suite B, Westminster, CO 80020 |
| Street Address |
4993 W ATLANTIC AVE |
| City | DELRAY BEACH |
| State | FL |
| Zip Code | 33445-3850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972722429 | Delray Family Dentistry P.a. | Dentist | 4993 W Atlantic Ave, Delray Beach, FL 33445-3850 | 2007-04-24 |
| 1750803896 | Idental of Delray Beach, Pllc | Dentist | 4993 W Atlantic Ave, Delray Beach, FL 33445-3850 | 2017-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346894839 | Timothy Joseph Marten Jr. | Physical Therapist | 601 N Congress Ave 411, Delray Beach, FL 33445 | 2019-08-01 |
| 1881252948 | Three Dots LLC | Behavioral Analyst | 1300 Nw 17th Ave Ste 272, Delray Beach, FL 33445 | 2019-06-04 |
| 1437649951 | Cardinal Care Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 601 N Congress Ave Ste 110b, Delray Beach, FL 33445 | 2018-05-10 |
| 1437654001 | Yvonne Marie Venton | Speech-Language Pathologist | 1221 Nw 19th Ter, Delray Beach, FL 33445 | 2018-03-27 |
| 1265935183 | Robert J Pina | Physical Therapist | 4800 Linton Blvd., Bldg. A-201, Delray Beach, FL 33445 | 2018-03-16 |
| 1447771159 | Julian Ibrahim Rashid | Pharmacist | 3030 Dorson Way, Delray Beach, FL 33445 | 2017-07-03 |
| 1285179333 | Sara Davis-larkins | Behavioral Analyst | 2061 Coral Trace Circle, Delray Beach, FL 33445 | 2016-12-28 |
| 1255876637 | Annette Annmarie Gray | Case Manager/Care Coordinator | 3624 Ave De Gien, Delray Beach, FL 33445 | 2016-12-21 |
| 1093262586 | Gordium Mental Health | Counselor | 4723 W Atlantic Ave St 21, Delray Beach, FL 33445 | 2016-09-01 |
| 1003279993 | Ted Paul | Home Health Aide | 2127 Sw 13 Ct, Delray Beach, FL 33445 | 2016-03-30 |
| Find all providers in zip 33445 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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|---|---|---|---|---|
| 1124142906 | Seacrest Optical Incorporated | Preferred Provider Organization | 7263 W Atlantic Ave, Delray Beach, FL 33446-1305 | 2007-03-19 |
| 1336452838 | Always Hope | Preferred Provider Organization | 1836 S Federal Hwy, Delray Beach, FL 33483-3311 | 2010-07-26 |
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| 1851850937 | Orkin Pest Control | Preferred Provider Organization | 4800 Woodlane Cir, Tallahassee, FL 32303-6858 | 2019-03-18 |
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| Find all providers with the same taxonomy | ||||
| City | DELRAY BEACH |
| Zip Code | 33445 |
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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.