MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS WATERFORD LAKES PLLC (NPI# 1881161297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881161297 |
Entity Type | Organization |
Organization Name | MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS WATERFORD LAKES PLLC |
Practice Address |
12150 Lake Underhill Rd Orlando FL 32825-5012 |
Practice Telephone | 3213197027 |
Enumeration Date | 2018-10-24 |
Last Update Date | 2018-10-24 |
Authorized Official Name | STEPHANIE GOMEZ (CREDENTIALING SUPERVISOR) |
Authorized Official Telephone | 3052742499 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
Street Address |
12150 LAKE UNDERHILL RD |
City | ORLANDO |
State | FL |
Zip Code | 32825-5012 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881255404 | Planes Dental East Orlando | Clinic/Center | 275 S Chickasaw Trail, Suite 2, Orlando, FL 32825 | 2019-06-25 |
1649837550 | Jessica Rivera | Social Worker | 10600 Bloomfield Drive, Apt 918, Orlando, FL 32825 | 2019-05-27 |
1326526708 | Total Family Care LLC | Family Medicine | 106 North Dean Road, Suite 1, Orlando, FL 32825 | 2018-07-30 |
1285121772 | Neurological Health Associates, L.L.C. | Psychiatry & Neurology | 11602 Lake Underhill Rd., Suite 104, Orlando, FL 32825 | 2018-04-19 |
1336636075 | Vijaya Laxmi Telu | Nurse Practitioner | 100 North Dean Rd Suite 101, Orlando, FL 32825 | 2018-04-18 |
1740795053 | Anna Louise Morris | Specialist/Technologist | 10719 Fairhaven Way, Orlando, FL 32825 | 2017-12-08 |
1568973352 | Darrenn G Cadet | Behavior Technician | 11121 Tortuga Bnd, Orlando, FL 32825 | 2017-10-19 |
1265942072 | Raquel B Saliba | Physical Therapist | 250 South Chickasaw Trail, Orlando, FL 32825 | 2017-10-06 |
1528585890 | Vreny Tatyana Gonzalez-casas | Behavior Technician | 3206 Mattson Dr, Orlando, FL 32825 | 2017-08-27 |
1184147803 | Alexandra Grace Mcmanus | Social Worker | 11258 Point Sylvan Circle, Orlando, FL 32825 | 2017-07-25 |
Find all providers in zip 32825 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235697707 | Pediatric Dental Group, LLC | Dentist | 12601 Narcoossee Rd, Unite 100a, Orlando, FL 32832 | 2019-03-04 |
1447726922 | A&m Dental Group LLC | Dentist | 8255 Lee Vista Blvd Ste F-g, Orlando, FL 32829-8018 | 2018-10-22 |
1295152312 | Hany S Azer | Dentist | 9161 Narcoossee Rd Ste 101b, Orlando, FL 32827 | 2014-03-26 |
1952664633 | Michael P. Dimauro D.d.s., P.a. | Dentist | 7424 Docs Grove Cir, Orlando, FL 32819-8010 | 2012-06-19 |
1427255694 | Olubisi O Aina | Dentist | 9161 Narcoossee Rd, Suite 101b, Orlando, FL 32827 | 2007-06-29 |
1285842658 | Serese Cannon Brooks | Dentist | 12711 Narcoossee Rd Ste 100, Orlando, FL 32832-6991 | 2007-05-18 |
1801915541 | David Lester Goldstein | Dentist | 7651 Ashey Park Court C, Suite 410, Orlando, FL 32835-6114 | 2007-03-27 |
1124143128 | Kristin M Foley | Dentist | 1549 S Alafaya Trl Ste 200, Orlando, FL 32828-8962 | 2007-03-20 |
1851439293 | Charles Morrison Robbins | Dentist | 508 N Mills, Suite B, Orlando, FL 32803 | 2007-02-01 |
1982785747 | Mubashir A Chaudhry Dmd Pllc | Dentist | 907 Outer Rd, Orlando, FL 32814-6653 | 2006-10-18 |
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.