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PROFESSIONAL DENTAL ALLIANCE OF ST. AUGUSTINE, PLLC
NPI 1386294072
Dentist - General Practice in St Augustine, FL

Active since September 16, 2019
2225 A1A S STE A3, ST AUGUSTINE, FL 32080(904) 201-3442 Get Directions Write a Review

NPPES record last updated: September 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Professional Dental Alliance Of St. Augustine, Pllc NPPES

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

PROFESSIONAL DENTAL ALLIANCE OF ST. AUGUSTINE, PLLC (NPI 1386294072) is a healthcare organization registered as a general practice in St Augustine, Florida and active in the NPI registry since September 2019. The organization lists Lauren Howard, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1386294072
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF ST. AUGUSTINE, PLLC
Location Address2225 A1A S STE A3St Augustine, FL 32080-6374
Mailing Address11 S Mill St Ste 200New Castle, PA 16101-3680
Phone(904) 201-3442
Organization SubpartNo
Authorized OfficialLauren HowardCredentialing Specialist · (757) 576-5479
Enumeration DateSeptember 16, 2019
✔ NPI 1386294072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
2225 A1A S STE A3, St Augustine, FL 32080
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

MICHELLE DEFELICE
Dentist
2225 A1A S STE A3
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-7300
DR. KELLY CARROTHERS MANTEI DDS
Dentist (General Practice)
2225 A1A S STE A3
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-7300
ST. JOHNS FAMILY DENTISTRY
Dentist
2225 A1A S STE A3
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-7300

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 Professional Dental Alliance Of St. Augustine, PLLC's NPI number?

The NPI number for Professional Dental Alliance Of St. Augustine, PLLC is 1386294072. It was assigned to this organization in the NPPES registry on September 16, 2019.

Where is Professional Dental Alliance Of St. Augustine, PLLC located?

Professional Dental Alliance Of St. Augustine, PLLC is located at 2225 A1a S Ste A3, St Augustine, FL 32080. The listed phone number is (904) 201-3442.

What is Professional Dental Alliance Of St. Augustine, PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Professional Dental Alliance Of St. Augustine, PLLC was last updated on September 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.