Smile So Big Flagler PLLC
Clinic/Center, Dental in St Augustine, FL. Organization (NPI-2).
NPI number1942021514
StatusActive
Last updated in NPPESOct 17, 2024
Details
- NPI
- 1942021514
- Entity type
- Organization (NPI-2)
- Legal business name
- Smile So Big Flagler PLLC
- Organization subpart
- No
- Enumeration date
- Oct 17, 2024
- Certification date
- Oct 17, 2024
- Last updated
- Oct 17, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Michael Versaggi DDS (Former Legal Business Name)
- Versaggi Dental (Former Legal Business Name)
Practice location
150 Malaga StSt Augustine, FL 32084-3521
Phone 904-829-9024
Mailing address
150 Malaga StSt Augustine, FL 32084-3521
Authorized official
Jonathan Aalona Montoya
Owner
9048299024
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Dental Clinic/Center providers in St Augustine, FL
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All 5 Dental Clinic/Center providers in St Augustine · All 2,630 providers in St Augustine
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