Ideal Dental - Winter Park PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IDEAL DENTAL - WINTER PARK PLLC

Practice address

415 S Orlando Ave Ste 212
Winter Park, FL 32789-3683

Phone

(407) 279-4000

Fax

(407) 794-4050

NPI assigned

Oct 1, 2021

Organization subpart

No

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

Authorized official

Name

Matthew Doan, DMD

Title

Owner

Phone

(972) 331-8079

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Shivani Kamaldevi Rajkumar, DMD

  • General Practice Dentistry
  • Winter Park, FL
  • NPI 1396470100
  NPD
• Ricky Joseph Cirujales Arazas, DDS

  • General Practice Dentistry
  • Orlando, FL
  • NPI 1841944568
  NPD (past)

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1013689678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840925",
            "telephone_number": "972-361-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S ORLANDO AVE STE 212",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893683",
            "telephone_number": "407-279-4000",
            "fax_number": "407-794-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL - WINTER PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-331-8079",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Hyman
• I Am Alive L.L.C.
• Ispa Iadanza
• Penny Elaine Iannotti, RMHCI
• Emily Mills Ibrahim, APRN
• Ralph P Ierardi, MD
• Daria Igudesman, RD
• Maria Patricia M. Ilagan, MD
• Images of Glory, Inc
• Images of Glory, Inc

• Dentist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.