{"npi":"1093815029","type":"NPI-2","status":"active","name":{"display":"Southpark Dental Group","other":[],"organization_name":"SOUTHPARK DENTAL GROUP","authorised_official":"John Cervenka"},"specialty":{"primary_taxonomy":"122300000X","primary_taxonomy_description":"Dentist","slug":"dentist","schema_org_specialty":null,"all":[{"code":"1223G0001X","description":"General Practice Dentistry","primary":false,"state":"FL","license":"9168"},{"code":"1223G0001X","description":"General Practice Dentistry","primary":false,"state":"FL","license":"13762"},{"code":"1223G0001X","description":"General Practice Dentistry","primary":false,"state":"FL","license":"14238"},{"code":"1223G0001X","description":"General Practice Dentistry","primary":false,"state":"FL","license":"16360"},{"code":"1223P0300X","description":"Periodontics","primary":false,"state":"FL","license":"12525"},{"code":"122300000X","description":"Dentist","primary":true,"state":"FL","license":"14090"}]},"addresses":[{"purpose":"LOCATION","street_1":"8801 COMMODITY CIR","city":"ORLANDO","state":"FL","postal_code":"328199053","country_code":"US","phone":"4072480100","fax":"4072488364"},{"purpose":"MAILING","street_1":"8801 COMMODITY CIR","city":"ORLANDO","state":"FL","postal_code":"328199053","country_code":"US","phone":"4072480100","fax":"4072488364"}],"license":{"state":"FL","number":"14090"},"identifiers":[{"type_code":"01","label":"Other","value":"836729","state":null,"issuer":"UNITED CONCORDIA"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-09-22","last_updated":"2025-09-11","_meta":{"source":"NPPES","snapshot_date":"2025-09-11","doc_url":"https://findmynpi.com/api"}}