Individual provider Active NPI

Nga Van

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1023217163
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17986 Issued in FL
Practice address
3804 E Colonial Dr
Orlando, FL 32803-5208
Phone
(407) 898-3800
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17986 FL Primary

Addresses

Primary practice location

3804 E Colonial Dr
Orlando, FL 32803-5208

Mailing address

2130 Autumn View Dr
Orlando, FL 32825-7425
Phone (954) 907-9297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123002477 FL Order and Referring Only - DentistPractitioner - Dentist 8921395120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN17986FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vanstar Dental General Practice Past Accepting new patients

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1023217163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 AUTUMN VIEW DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328257425",
            "telephone_number": "954-907-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035208",
            "telephone_number": "407-898-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "NGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.