Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Main Street Children's Dentistry and Orthodontics of Orange City, PA

Organization Dentist · NPI 1124393822

Main Street Children's Dentistry and Orthodontics of Orange City, PA provides Dentist services in Orange City, Florida. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2435 S Volusia Ave Ste D2
Orange City, FL 32763-7643 Not confirmed with CMS for 11 years — call before visiting
Phone: (386) 775-0833
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X
Dentist Taxonomy 122300000X
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X

Record details

NPI number1124393822
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephanie Gomez — Provider Relations Specialist · (305) 274-2499
NPI enumeratedMarch 13, 2012
Last updated in NPPESMarch 26, 2015
Mailing address13195 Sw 134th St Fl 2, Miami, FL 33186-4461

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