MEDICARE: COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.

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	122300000X	Dentist

General Provider Information

NPI Number	:	1396604856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.

Provider Business Mailing Address
First Line	:	1485 SUN MARKET PL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-1951
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1485 SUN MARKET PL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-1951
Country	:	US
Telephone Number	:	941-239-5250
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	CEMYIRA MCDOUGAL
Credential	:
Telephone Number	:	217-764-8609

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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