MEDICARE: ANYTIME DENTAL CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1922935634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANYTIME DENTAL CENTERS, LLC

Provider Business Mailing Address
First Line	:	3908 SPYGLASS HILL LN
Second Line	:
City	:	MIDDLEBURG
State	:	FL
Zip	:	32068-9116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 N COURTENAY PKWY
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-5213
Country	:	US
Telephone Number	:	321-352-6740
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	JOE SHIPPEE
Credential	:
Telephone Number	:	904-472-3839

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ANYTIME DENTAL CENTERS, LLC ” Practice Location

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