Healthcare Provider Details

I. General information

NPI: 1356257240
Provider Name (Legal Business Name): SUN CITY MODERN DENTISTRY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10326 PASEO AL MAR BLVD
SUN CITY CENTER FL
33573
US

IV. Provider business mailing address

PO BOX 660041
DALLAS TX
75266-0041
US

V. Phone/Fax

Practice location:
  • Phone: 813-725-4226
  • Fax: 813-419-6189
Mailing address:
  • Phone: 714-845-8890
  • Fax: 303-952-0892

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: NICHOLAS R BUTTON
Title or Position: OWNER
Credential: DMD
Phone: 813-725-4226