MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WELLINGTON PA NPI 1760687149

NPI Information

  • NPI: 1760687149
  • Provider Name: MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WELLINGTON, PA
  • Classification: Dentist - 1223X0400X
  • Specialization: Orthodontics and Dentofacial Orthopedics
  • Entity Type: Organization
  • Address: 11903 SOUTHERN BLVD.
    SUITE #102
    ROYAL PALM BEACH, FL
    ZIP 33411
  • Phone: (561) 422-2940

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NPI Details

MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WELLINGTON, PA is an orthodontics and dentofacial orthopedics dentist in Royal Palm Beach, FL. The provider is that area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WELLINGTON, PA NPI is 1760687149. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11903 SOUTHERN BLVD.
SUITE #102
ROYAL PALM BEACH, FL
ZIP 33411
Phone: (561) 422-2940
Fax: (561) 422-2945

The provider's authorized official is Stephanie Gomez .
The authorized official title is Provider Relations and has the following contact phone number (305) 274-2499.

The enumeration date for this NPI number is 6/18/2007 and was last updated on 8/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223X0400XDentistOrthodontics and Dentofacial OrthopedicsFLORIDAYes

What is NPI?

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This page was last updated on: 11/21/2025

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