MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS OF LAKEWOOD RANCH PLL
NPI 1790273159
Dentist - Orthodontics and Dentofacial Orthopedics in Bradenton, FL

Active since May 01, 2018
11649 SR 70 EAST, SUITE 109, BRADENTON, FL 34202(941) 209-1213 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll NPPES

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

MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS OF LAKEWOOD RANCH PLL (NPI 1790273159) is a healthcare organization registered as an orthodontics and dentofacial orthopedics in Bradenton, Florida and active in the NPI registry since May 2018. The organization lists Stephanie Gomez, Credentialing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1790273159
Entity TypeOrganization
Primary Taxonomy1223X0400X
Legal Business NameMAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS OF LAKEWOOD RANCH PLL
Location Address11649 SR 70 EAST, SUITE 109Bradenton, FL 34202
Mailing Address6240 Lake Osprey Dr Dept 50226Lakewood Ranch, FL 34240-8421
Organization SubpartNo
Authorized OfficialStephanie GomezCredentialing Supervisor · (305) 274-2499
Enumeration DateMay 1, 2018
NPI 1790273159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

11649 SR 70 EAST, SUITE 109, Bradenton, FL 34202

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

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 Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll's NPI number?

The NPI number for Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll is 1790273159. It was assigned to this organization in the NPPES registry on May 1, 2018.

Where is Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll located?

Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll is located at 11649 Sr 70 East, Suite 109, Bradenton, FL 34202. The listed phone number is (941) 209-1213.

What is Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Main Street Childrens Dentistry And Orthodontics Of Lakewood Ranch Pll was last updated on May 1, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.