Healthcare Provider Details

I. General information

NPI: 1891600193
Provider Name (Legal Business Name): AMG DENTISTRY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2467 ENTERPRISE RD STE F
CLEARWATER FL
33763-1724
US

IV. Provider business mailing address

4102 W KNIGHTS AVE
TAMPA FL
33611-1316
US

V. Phone/Fax

Practice location:
  • Phone: 727-796-1713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ARIANA GODOY
Title or Position: OWNER
Credential: DDS
Phone: 516-660-1838