SOUTHEASTERN DENTAL GROUP (NPI# 1861403883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861403883 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN DENTAL GROUP |
| Other Organization Name | FAMILY AND COSMETIC DENTISTRY AT VISTA LAKES |
| Practice Address |
6415 South Chickasaw Trail Orlando FL 32829 |
| Practice Telephone | 4073822282 |
| Practice Fax Number | 4073822858 |
| Mailing Telephone | 4073822282 |
| Mailing Fax Number | 4073822858 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL J MORRA (MANAGING PARTNER) |
| Authorized Official Telephone | 4073822282 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DN15633 | FL | Dental Providers |
| Y | 122300000X | Dentist | DN15714 | FL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Family And Cosmetic Dentistry At Vista Lakes | Doing Business As Name - Organization |
| Street Address |
6415 SOUTH CHICKASAW TRAIL |
| City | ORLANDO |
| State | FL |
| Zip Code | 32829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134614670 | Nashali Marie Melendez | Specialist/Technologist | 2736 Palm Isle Way, Orlando, FL 32829 | 2018-06-27 |
| 1710490354 | Kinesist LLC | Physical Therapist | 5069 Walnutridge Drive, Orlando, FL 32829 | 2017-11-06 |
| 1093175812 | Senior Garden Asssisted Living, LLC | Assisted Living Facility | 4034 Eagle Feather Dr, Orlando, FL 32829 | 2016-03-07 |
| 1689910283 | Shana Symone Ferguson | Occupational Therapist | 10060 Lethbridge Drive, Orlando, FL 32829 | 2012-12-31 |
| 1609033729 | Physician Associates LLC | Family Medicine | 6447 S. Chickasaw Trail, Orlando, FL 32829 | 2008-05-16 |
| 1992983225 | Eyeglass World #95 | Eyewear Supplier (Equipment, not the service) | 8236 Lee Vista Blvd, Suite A4 - A6, Orlando, FL 32829 | 2008-02-08 |
| 1831286814 | Beena Naz | Internal Medicine | 4882 Quality Trail, Orlando, FL 32829 | 2006-10-09 |
| 1477646974 | Cheryl D Sims | Nurse Practitioner | 8035 Lee Vista Blvd, Orlando, FL 32829 | 2006-10-02 |
| 1104239268 | Mahiry Romero-salinas | Internal Medicine | 4882 Quality Trail, Orlando, FL 32829 | 2014-06-06 |
| 1487963450 | Joel Ramos-tirado | Internal Medicine | 4882 Quality Trail, Orlando, FL 32829 | 2010-09-24 |
| Find all providers in zip 32829 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917215 | Christian Arcolin Lo Monaco | Dentist | 8865 Commodity Cir Ste 6, Orlando, FL 32819-9077 | 2020-06-22 |
| 1821625161 | Strategic Dental P.a. | Dentist | 12250 Strategy Blvd Ste 437, Orlando, FL 32817-2108 | 2020-03-26 |
| 1538794185 | Nona Dentists 3, Pa | Dentist | 12964 Narcoossee Rd, Orlando, FL 32832-6925 | 2020-03-04 |
| 1245863463 | Leonard S Kaplan Dds Pa | Dentist | 12131 S Apopka-vineland Rd, Orlando, FL 32836-6802 | 2020-02-17 |
| 1811546856 | Leslie Joelle Fernandez Bencosme | Dentist | 13670 Boggy Creek Rd, Orlando, FL 32824-9203 | 2019-09-11 |
| 1841844321 | Ryan Christopher Huhn | Dentist | 1100 S Orange Ave, Orlando, FL 32806-1249 | 2019-08-01 |
| 1740848167 | Quy Phan | Dentist | 3502 Avalon Park West Blvd, Orlando, FL 32828-7859 | 2019-05-31 |
| 1598232852 | Sodo Smiles Dentistry, Pa | Dentist | 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 | 2018-10-25 |
| 1407330145 | Providence Dental LLC | Dentist | 12450 E. Colonial Drive Suite 124, Orlando, FL 32826 | 2018-09-19 |
| 1306332143 | Peter Fereg | Dentist | 5979 Vineland Rd Ste 205, Orlando, FL 32819-7855 | 2018-07-05 |
| 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.