Organization Active NPI

Designer Smiles PA

  • Dentist
  • Sanford, FL
National Provider Identifier
1003276007
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DESIGNER SMILES PA
Practice address
5030 Sr 46 Ste 108
Sanford, FL 32771-9247
Phone
(407) 894-3571
Fax
(407) 895-5511
NPI assigned
Mar 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Emelia Ospina, RN
Title
Clinical Manager
Phone
(407) 894-3571

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X FL Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

5030 Sr 46 Ste 108
Sanford, FL 32771-9247

Mailing address

PO Box 130
Osteen, FL 32764-0030
Phone (407) 894-3571

Other identifiers 1

IdentifierTypeStateIssuer
1255352142MedicaidFL

National Provider Directory

National Provider Directory

Locations

316 Groveland St
Orlando, FL 32804
Phone (407) 896-9660

5030 Sr 46
Ste 108
Sanford, FL 32771
Phone (407) 894-3571

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1003276007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "OSTEEN",
            "state": "FL",
            "postal_code": "327640030",
            "telephone_number": "407-894-3571",
            "fax_number": "407-895-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 SR 46 STE 108",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327719247",
            "telephone_number": "407-894-3571",
            "fax_number": "407-895-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIGNER SMILES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "OSPINA",
        "authorized_official_first_name": "EMELIA",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "407-894-3571",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255352142",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.