Active NPI
Briana Alexis Fannin, DMD
- Dentist
- Clermont, FL
National Provider Identifier
1033085733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN31080
- Practice address
- 19450 Heavens Hill LN
Clermont, FL 34715-9262 - Phone
- (407) 456-4307
- NPI assigned
- Oct 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | DN31080 | FL | Primary |
Addresses
Primary practice location
19450 Heavens Hill LN
Clermont, FL 34715-9262
Mailing address
19450 Heavens Hill LN
Clermont, FL 34715-9262
Phone (407) 456-4307
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 |
|---|---|---|---|
| DN31080 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760140800000",
"number": "1033085733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19450 HEAVENS HILL LN",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347159262",
"telephone_number": "407-456-4307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19450 HEAVENS HILL LN",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347159262",
"telephone_number": "407-456-4307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "BRIANA",
"middle_name": "ALEXIS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-11",
"last_updated": "2025-10-11",
"certification_date": "2025-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "FL",
"license": "DN31080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.