KREATIVE DENTAL CARE PA (NPI# 1861967333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861967333 |
| Entity Type | Organization |
| Organization Name | KREATIVE DENTAL CARE PA |
| Practice Address |
120 Carter Blvd Ste 7 Polk City FL 33868-8912 |
| Practice Telephone | 8639840000 |
| Mailing Telephone | 8639840000 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | DR. YALICE MARIELY CARDONA (PRESIDENT) |
| Authorized Official Telephone | 7875522631 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
120 CARTER BLVD STE 7 |
| City | POLK CITY |
| State | FL |
| Zip Code | 33868-8912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628112 | Roshni Amin | Dentist | 120 Carter Blvd Ste 7, Polk City, FL 33868-8912 | 2020-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710089669 | Jacqueline Anne Futch | Pharmacist | 108 N Commonwealth Ave, Polk City, FL 33868 | 2006-09-02 |
| 1508887159 | Carolyn A. Chenowith | Specialist | 7053 Tall Pine Rd, Polk City, FL 33868 | 2006-07-21 |
| 1316160005 | Jacqueline Yvonne Williams | Social Worker | 3800 Big Bend Trl, Polk City, FL 33868-3001 | 2007-04-11 |
| 1821205436 | Jennifer Jean Friddle | Physical Therapy Assistant | 6982 Berkley Rd, Polk City, FL 33868-3714 | 2007-05-16 |
| 1750749388 | Beverly Reaves | Registered Nurse | 569 Homecoming Way, Polk City, FL 33868-5151 | 2016-02-10 |
| 1457907735 | Paula Cleopatra Quintero | Developmental Therapist | 15009 Commonwealth Ave N, Polk City, FL 33868-5612 | 2019-08-13 |
| 1679810972 | Polk Correctional Institution | Health Maintenance Organization | 10800 Evans Rd, Polk City, FL 33868-6925 | 2013-01-08 |
| 1508274226 | Tommy L Louisville Md Pa | Non-Pharmacy Dispensing Site | 235 N Commonwealth Ave, Polk City, FL 33868-8821 | 2014-07-25 |
| 1972075992 | Jaime Stewart | Technician | 3268 Chisholm Trl, Polk City, FL 33868-8837 | 2019-01-02 |
| 1730324690 | David W Goldston | Dentist | 120 Carter Blvd, Suite #7, Polk City, FL 33868-8908 | 2008-12-08 |
| Find all providers in zip 33868 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184041048 | Cornerstone Dental Staffing LLC | Clinic/Center | 1010 S 3rd St Ste 2a, Polk City, IA 50226-1181 | 2014-03-27 |
| 1720400773 | Cornerstone Dental of Polk City LLC | Clinic/Center | 1010 S 3rd St Ste 2a, Polk City, IA 50226-1181 | 2014-01-10 |
| 1215359393 | Cornerstone Dental Group LLC | Clinic/Center | 1010 S 3rd St Ste 2a, Polk City, IA 50226-1181 | 2014-01-09 |
| 1528301058 | Artistic Dental of Polk City, LLC | Clinic/Center | 120 Carter Blvd, Suite 7, Polk City, FL 33868-8908 | 2013-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376525 | Hoffmann Holdings Inc | Clinic/Center | 515 Semoran Blvd Ste 1000, Casselberry, FL 32707-5341 | 2020-11-06 |
| 1811598238 | Dental Plus Management, LLC | Clinic/Center | 16 Ne 2nd Ave, Deerfield Beach, FL 33441-3504 | 2020-11-03 |
| 1750981452 | Smillie Dental Pllc | Clinic/Center | 5537 S Williamson Blvd Ste 675, Port Orange, FL 32128-8314 | 2020-10-30 |
| 1609476027 | R & R Dentistry Pa | Clinic/Center | 6290 Linton Blvd Unit 202, Delray Beach, FL 33484-6409 | 2020-10-26 |
| 1295334126 | Friedman Dental Group Miami, Pllc | Clinic/Center | 1717 N Bayshore Dr Ste 219, Miami, FL 33132-1196 | 2020-10-21 |
| 1376142547 | Trm Global Enterprise,llc. | Clinic/Center | 145 Crawl Key Ct, Deland, FL 32720-3951 | 2020-10-20 |
| 1568060762 | Bawany LLC | Clinic/Center | 15130 Springview St, Tampa, FL 33624-2332 | 2020-10-12 |
| 1992312730 | Rocent Dental Care, Inc. | Clinic/Center | 1 Sw 129th Ave Ste 406, Pembroke Pines, FL 33027-1718 | 2020-09-25 |
| 1730795857 | Kind Smiles Dental Health | Clinic/Center | 11155 State Road 70 E, Lakewood Ranch, FL 34202 | 2020-09-23 |
| 1952916306 | Simmons Services LLC | Clinic/Center | 2500 Sw 107th Ave Ste 45, Miami, FL 33165-2492 | 2020-09-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KREATIVE DENTAL CARE 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.