NPI Code Detail JSON Logo

1407617459 NPI number — COASTAL KIDS DENTISTRY

NPI Number: 1407617459
Health Care Provider/Practitioner: COASTAL KIDS DENTISTRY

Information about “1407617459” NPI (COASTAL KIDS DENTISTRY) exists in 1407617459 in HTML format HTML  |  1407617459 in plain Text format TXT  |  1407617459 in PDF (Portable Document Format) PDF  |  1407617459 in an XML format XML  formats.

NPI Number : 1407617459 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407617459",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "COASTAL KIDS DENTISTRY",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "288 REDFERN VLG",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ST SIMONS ISLAND",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31522-2536",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "912-638-9090",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2487 DEMERE RD STE 300",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ST SIMONS ISLAND",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31522-5642",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "912-638-9302",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/17/2024",
    "LastUpdateDate": "01/17/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SPIRES",
    "AuthorizedOfficialFirstName": "SAVANNAH",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "912-207-0223",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QD0000X",
        "TaxonomyName": "Dental Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.