IDEAL DENTAL OF LAKE NONA (NPI# 1821609454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821609454 |
| Entity Type | Organization |
| Organization Name | IDEAL DENTAL OF LAKE NONA |
| Practice Address |
12851 Narcoossee Rd Ste 400 Orlando FL 32832-7155 |
| Mailing Address |
12770 Merit Dr Ste 850 Dallas TX 75251-1438 |
| Practice Telephone | 4077491560 |
| 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 | 4077491560 |
| 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 |
12851 NARCOOSSEE RD STE 400 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32832-7155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482728 | Maria Belen Bengolea | Behavior Technician | 10920 Moss Park Rd. Suite 130, Orlando, FL 32832 | 2020-09-23 |
| 1942819495 | Oasis Counseling Services | Community/Behavioral Health | 11954 Narcoossee Rd., Ste 2 #278, Orlando, FL 32832 | 2020-07-29 |
| 1538628219 | Lake Nona Endodontics Pa | Dentist | 13571 Narcoossee Road, Orlando, FL 32832 | 2019-03-13 |
| 1235697707 | Pediatric Dental Group, LLC | Dentist | 12601 Narcoossee Rd, Unite 100a, Orlando, FL 32832 | 2019-03-04 |
| 1518451343 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 13072 Narcoossee Rd, Orlando, FL 32832 | 2018-06-15 |
| 1356834345 | Cachae Cierra Mason | Clinic/Center | 9412 Randal Park Blvd, Unit 6127, Orlando, FL 32832 | 2018-06-13 |
| 1598258832 | Magda Liliana Sanchez | Behavior Technician | 14046 Millington St, Orlando, FL 32832 | 2018-06-12 |
| 1982106423 | Grace-ann Lewis | Behavior Technician | 10920 Moss Park Road Suite 100, Orlando, FL 32832 | 2018-03-01 |
| 1427574151 | Nona Dentists, Pa | Dentist | 12711 Narcoossee Rd, Building B, Suite 100, Lake Nona, Orlando, FL 32832 | 2017-08-15 |
| 1578084281 | Crispus Nyambariga Ombui | Nurse Anesthetist, Certified Registered | 9452 Randal Park Blvd, Unit 2-2126, Orlando, FL 32832 | 2017-07-03 |
| Find all providers in zip 32832 | ||||
| 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 |
| 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 |
| 1811553076 | Connor Van | Dentist | 7651 Ashley Park Ct Ste 406, Orlando, FL 32835-6114 | 2019-05-14 |
| 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.