Welltide Orthodontics Llc

LBN: Welltide Orthodontics Llc
Welltide Orthodontics Llc is an health care organization with primary practice located at 420 Paseo Reyes Dr , St Augustine FL 32095-8558. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Welltide Orthodontics Llc can be contacted via phone (904) 671-6996, or through Podray, Susan Sara via phone (678) 787-3863.

Contact Information

Primary practice address
420 Paseo Reyes Dr St Augustine FL 32095-8558
Phone: (904) 671-6996
Fax: (904) 671-7002
Website:
Map and Directions
Authorized official contact:
Name: Podray, Susan Sara DMD, MS
Phone: (678) 787-3863

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X

Profile Details

NPI number 1568370104
LBN Legal business name Welltide Orthodontics Llc
DBA Doing business as
Authorized official Podray, Susan Sara DMD, MS
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2026
Last updated Sep 1st, 2026 - about 2 months 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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