NPI 1194119255 · live from the CMS NPI Registry
A Family Dentist PA
Dentist, General Practice in New Port Richey, FL. National Provider Identifier 1194119255, active.
NPI record
| NPI | 1194119255 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 5153 Marine Pkwy, New Port Richey, FL 34652 |
| Practice phone | 727-645-6932 |
| Enumerated | March 26, 2015 |
| Last updated | March 26, 2015 |
| Authorized official | Cristen Mendoza, Owner/Dentist |
| Other names | A Family Dentist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | DN18780 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.