Daniel Yevseyevich
Individual provider Active NPI Dentist · Lake Mary, FL
NPI 1013852029 · NPPES record last updated Apr 23, 2026
Key facts
- NPI
- 1013852029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN31527 (FL)
- Practice address
- 3779 Lake Emma Rd
Lake Mary, FL 32746-6156 - Phone
- (407) 547-1359
- NPI assigned
- Apr 23, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
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 |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN31527 | FL | Yes |
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
Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.