OrganizationActive
Fl Southern Dental PA
NPI 1265133185 · General Practice Dentistry · St Augustine, FL
Fl Southern Dental PA is a General Practice Dentistry organization in St Augustine, FL (NPI 1265133185).
Provider details
- NPI number
- 1265133185
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Parent organization
- Fl Southern Dental PA
- Organization subpart
- Yes
- Authorized official
- Erika Menjivar, Sr. Credentialing Specialist(469) 596-6137
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
100 Whetstone Pl Ste 308
St Augustine, FL 32086-5775
Phone: (904) 810-2345
Street-level locationGet directions
Mailing address
5830 Granite Pkwy Ste 780
Plano, TX 75024-6775
Other names (DBA / former)
- Doing business as
- Matanzas Dental Group
Registry dates
- Enumerated
- 2023-03-16
- Last updated
- 2026-03-17
- Certified
- 2026-03-17
Frequently asked questions
- What is Fl Southern Dental PA's NPI number?
- Fl Southern Dental PA's National Provider Identifier (NPI) is 1265133185, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fl Southern Dental PA?
- Fl Southern Dental PA is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Fl Southern Dental PA located?
- Fl Southern Dental PA's practice location on file with NPPES is 100 Whetstone Pl Ste 308, St Augustine, FL 32086-5775.
- What is Fl Southern Dental PA's phone number?
- The practice phone number listed in the NPPES registry for Fl Southern Dental PA is (904) 810-2345.
- Who is the authorized official for Fl Southern Dental PA?
- The authorized official listed on Fl Southern Dental PA's NPPES record is Erika Menjivar, Sr. Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fl Southern Dental PA's NPI active?
- Yes — Fl Southern Dental PA's NPI (1265133185) is active in the NPPES registry as of the last update on 2026-03-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.