IDEAL DENTAL OF LEE VISTA (NPI# 1689285207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689285207 |
| Entity Type | Organization |
| Organization Name | IDEAL DENTAL OF LEE VISTA |
| Practice Address |
6784 Eagle Watch Dr Ste 550 Orlando FL 32822-2355 |
| Mailing Address |
12770 Merit Dr Ste 850 Dallas TX 75251-1438 |
| Practice Telephone | 4079827996 |
| Mailing Telephone | 9723610600 |
| Mailing Fax Number | 9723310540 |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |
| Authorized Official Name | JOSHUA COUSSA (OWNER) |
| Authorized Official Telephone | 4079827996 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
6784 EAGLE WATCH DR STE 550 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32822-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871149120 | Damien Phillips Blanco | Dentist | 6784 Eagle Watch Dr Ste 550, Orlando, FL 32822-2355 | 2019-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697335 | Julie C Figaro | Physical Therapy Assistant | 7209 Curry Ford Ste E, Orlando, FL 32822 | 2020-10-26 |
| 1912411240 | Advanced Mobility of Central Florida Corp | Durable Medical Equipment & Medical Supplies | 5844 S. Semoran Blvd., Orlando, FL 32822 | 2017-11-22 |
| 1467965434 | Ashley Morgan Mcglashen | Behavior Technician | 5773 Gatlin Ave, Orlando, FL 32822 | 2017-11-13 |
| 1801315312 | Ashleigh Boyle | Counselor | 5768 S. Semoran Blvd, Orlando, FL 32822 | 2017-09-15 |
| 1528584943 | Carlos Mario Davila Sr. | Psychologist | 7113 Lakner Way, Orlando, FL 32822 | 2017-08-17 |
| 1760922876 | Guardians of Care, LLC | Family Medicine | 733 S Goldenrod Rd Ste B, Orlando, FL 32822 | 2017-03-08 |
| 1457808529 | Rachel Richardson | Counselor | 5758 S. Seminole Blvd., Orlando, FL 32822 | 2016-09-07 |
| 1215392154 | Teresita Henao | Nurse Practitioner | 900 S Goldenrod Rd Ste B, Orlando, FL 32822 | 2015-12-18 |
| 1407221831 | Jennifer Castro | Psychologist | 4153 S Semoran, Unit 10, Orlando, FL 32822 | 2015-12-10 |
| 1821466616 | Miguel Yanes Delgado | Nurse Practitioner | 5564 East Grant St, Orlando, FL 32822 | 2015-09-10 |
| Find all providers in zip 32822 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295332013 | Dentists of Nona, Pa | Dentist | 14019 Narcoossee Rd Ste 135, Orlando, FL 32832-7162 | 2020-10-05 |
| 1720690886 | Ideal Dental of University Pointe | Dentist | 11871 University Blvd, Suite 110, Orlando, FL 32817 | 2020-08-20 |
| 1821609454 | Ideal Dental of Lake Nona | Dentist | 12851 Narcoossee Rd Ste 400, Orlando, FL 32832-7155 | 2020-08-17 |
| 1063023703 | Muhammad Sheryar Khan | Dentist | 11712 Savona Way, Orlando, FL 32827-7243 | 2020-08-16 |
| 1306464805 | Orlando Implants Center Pa | Dentist | 300 Gatlin Ave Ste 1-b, Orlando, FL 32806-6951 | 2020-07-10 |
| 1720601628 | Amber Lynn Medellin | Dentist | 7861 Jubilee Park Blvd Apt 2412, Orlando, FL 32822-5258 | 2020-05-26 |
| 1134741960 | Karoline Anne Biami | Dentist | 1444 Alden Rd Apt 502, Orlando, FL 32803-1973 | 2020-05-14 |
| 1568083020 | Ricardo J Cermeno Sr. | Dentist | 6509 Conroy Rd Apt 114, Orlando, FL 32835-3501 | 2020-05-06 |
| 1871149120 | Damien Phillips Blanco | Dentist | 6784 Eagle Watch Dr Ste 550, Orlando, FL 32822-2355 | 2019-08-13 |
| 1144872029 | My Forever Smiles LLC | Dentist | 7208 W Sand Lake Rd Ste 104, Orlando, FL 32819-5277 | 2019-07-11 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.