ADVANTAGE DENTAL ORAL HEALTH CENTER OF FLORIDA PA
NPI 1285375873
Dentist - General Practice in Crestview, FL

Q: What is Advantage Dental Oral Health Center Of Florida PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since April 06, 2022CLIA 10D2275695 · Waiver

775 N FERDON BLVD STE A, CRESTVIEW, FL 32536(850) 220-1120 Get Directions Write a Review

NPPES record last updated: August 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 3, 2022, Apr 6, 2022 (2 updates tracked since 2022).

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About Advantage Dental Oral Health Center Of Florida Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANTAGE DENTAL ORAL HEALTH CENTER OF FLORIDA PA (NPI 1285375873) is a healthcare organization registered as a general practice in Crestview, Florida and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Sherrie Edmondson, Manager, Licensing & Certification, as its authorized official.

NPPES Registry Identity

NPI1285375873

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameADVANTAGE DENTAL ORAL HEALTH CENTER OF FLORIDA PA

Location Address775 N FERDON BLVD STE ACrestview, FL 32536-2167

Mailing Address3322 W End Ave Ste 400Nashville, TN 37203-6805 · (629) 999-5014

Phone(850) 220-1120

Organization SubpartNo

Authorized OfficialSherrie EdmondsonManager, Licensing & Certification · (629) 999-5014

Enumeration DateApril 6, 2022

Last NPPES UpdateAugust 3, 20222 updates tracked since enumeration

NPPES CertifiedAugust 3, 2022

✔ NPI 1285375873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Also ListedDentistTaxonomy 122300000X

775 N FERDON BLVD STE A, Crestview, FL 32536

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2275695

Advantage Dental Oral Health Center Of Fl PA · Crestview, FL

Active · expires Jan 25, 2027

CLIA Number10D2275695

Laboratory TypeDental Practice

Certificate Effective DateJanuary 26, 2025

Certificate Expiration DateJanuary 25, 2027

Laboratory DirectorNeil Williams

Laboratory Phone(541) 527-0118

Laboratory LocationAdvantage Dental Oral Health Center Of Fl PA775 N Ferdon Blvd, Crestview, FL 32536

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RACHEL DUCKWORTH DMD

Dentist

775 N FERDON BLVD STE A
CRESTVIEW, FL 32536

Okaloosa County (850) 613-5035

YUL PRINCE

Dentist (General Practice)

775 N FERDON BLVD STE A
CRESTVIEW, FL 32536

Okaloosa County (850) 613-5035

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advantage Dental Oral Health Center Of Florida PA's NPI number?

The NPI number for Advantage Dental Oral Health Center Of Florida PA is 1285375873. It was assigned to this organization in the NPPES registry on April 6, 2022.

Where is Advantage Dental Oral Health Center Of Florida PA located?

Advantage Dental Oral Health Center Of Florida PA is located at 775 N Ferdon Blvd Ste A, Crestview, FL 32536. The listed phone number is (850) 220-1120.

What is Advantage Dental Oral Health Center Of Florida PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Advantage Dental Oral Health Center Of Florida PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2275695) is associated with this NPI, valid through January 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advantage Dental Oral Health Center Of Florida PA was last updated on August 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.