Southpark Dental Group

LBN: Southpark Dental Group
Southpark Dental Group is an health care organization with primary practice located at 8801 Commodity Cir , Orlando FL 32819-9053. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice, Dental Providers / Periodontics. Dental Providers / Dentist is the primary health care specialty. Southpark Dental Group can be contacted via phone (407) 248-0100, or through Cervenka, John F via phone (407) 248-0100.

Contact Information

Primary practice address
8801 Commodity Cir Orlando FL 32819-9053
Phone: (407) 248-0100
Fax: (407) 248-8364
Website:
Map and Directions
Authorized official contact:
Name: Cervenka, John F Doctor of Dental Surgery (DDS)
Phone: (407) 248-0100

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 14090 Florida
Dental Providers / General Practice 1223G0001X 9168 Florida
Dental Providers / General Practice 1223G0001X 13762 Florida
Dental Providers / General Practice 1223G0001X 14238 Florida
Dental Providers / General Practice 1223G0001X 16360 Florida
Dental Providers / Periodontics 1223P0300X 12525 Florida

Profile Details

NPI number 1093815029
LBN Legal business name Southpark Dental Group
DBA Doing business as
Authorized official Cervenka, John F Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 22nd, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093815029 NPPES
Other 836729 UNITED CONCORDIA

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