Unknown Individual – Dentist, NPI 1174531966

Unknown Individual is a healthcare provider. based in Port orange, Florida. specializing in Dentist. They hold a License No. DN12614 (FL). The NPI Number for Unknown Individual is 1174531966

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174531966
Phone
(386) 322-7786
Address
1525 HERBERT ST
Deactivation Date
9 May 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1525, Herbert Street, Thompson Pump & Manufacturing Co., Port Orange, Volusia County, Florida, 32129, United States

    SUITE 101

    PORT ORANGE, FL 32129

    Phone: (386) 322-7786

    Fax: (386) 761-3920

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32129)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1174531966 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Dentist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Port Orange?
Public fields place Unknown Individual around Port Orange, Florida. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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