MCKISSOCK CORP NPI 1831459551

NPI Information

  • NPI: 1831459551
  • Provider Name: MCKISSOCK CORP
  • Classification: Dentist - 122300000X
  • Entity Type: Organization
  • Doing Business As: WINDERMERE DENTISTRY
  • Address: 4769 THE GROVE DR.
    SUITE 100
    WINDERMERE, FL
    ZIP 34786
  • Phone: (407) 909-1099

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NPI Details

MCKISSOCK CORP is a dentist in Windermere, FL. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. MCKISSOCK CORP NPI is 1831459551. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Windermere Dentistry.

The provider's business location address is:

4769 THE GROVE DR.
SUITE 100
WINDERMERE, FL
ZIP 34786
Phone: (407) 909-1099

The provider's authorized official is Matthew Dean Mckissock .
The authorized official title is Owner/president and has the following contact phone number (407) 909-1099.

The enumeration date for this NPI number is 5/29/2012 and was last updated on 5/29/2012.

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
1122300000XDentistDN16810FLORIDAYes

What is NPI?

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

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