Provider Demographics
NPI:1255084059
Name:MID-FLORIDA ENDODONTICS - DR. PHILLIPS, PLLC
Entity type:Organization
Organization Name:MID-FLORIDA ENDODONTICS - DR. PHILLIPS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPADHYAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-581-9515
Mailing Address - Street 1:7932 W SAND LAKE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7932 W SAND LAKE RD STE 304
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7230
Practice Address - Country:US
Practice Address - Phone:407-581-9515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty