Active NPI
Daniel Yevseyevich
- Dentist
- Lake Mary, FL
National Provider Identifier
1013852029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN31527
- Practice address
- 3779 Lake Emma Rd
Lake Mary, FL 32746-6156 - Phone
- (407) 547-1359
- NPI assigned
- Apr 23, 2026
- Last updated
- Apr 23, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN31527 | FL | Primary |
Addresses
Primary practice location
3779 Lake Emma Rd
Lake Mary, FL 32746-6156
Mailing address
3779 Lake Emma Rd
Lake Mary, FL 32746-6156
Phone (407) 547-1359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN31527 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Mary Modern Dentistry, PA | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1013852029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3779 LAKE EMMA RD",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327466156",
"telephone_number": "407-547-1359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3779 LAKE EMMA RD",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327466156",
"telephone_number": "407-547-1359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEVSEYEVICH",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-23",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN31527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.