Walmir Baldocchi Da Costa, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN22582 Issued in FL

Practice address

1340 E Orange Ave
Eustis, FL 32726-4343

Phone

(352) 273-5440

NPI assigned

Jul 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Oakland Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Winter Garden, FL
  • NPI 1629751375
  NPD Authorized official

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

{
    "created_epoch": "1499126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1023539699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 E ORANGE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327264343",
            "telephone_number": "352-333-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 E ORANGE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327264343",
            "telephone_number": "352-273-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA COSTA",
        "first_name": "WALMIR",
        "middle_name": "BALDOCCHI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-04",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN22582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette Marie Crouse, M.A., LMHC
• Joseph Patrick Currid, ED.S.
• Brandy Lee Currie, LCSW
• Autumn Curry
• Margarita Custodio
• Brandel Nicole Dailey, NP
• Daisys Physical Therapy and Wellness Center Inc
• Barry Daly, ED.D.,LMHC,BCBA-D
• Augustus M Davis Jr., PT
• Daystar Outreach Community Services Inc

• Pediatric Dentistry in Eustis, FL
• Providers in Eustis, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.