Altamonte Mall Dental PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN16377 Issued in FL

Legal business name

ALTAMONTE MALL DENTAL PA

Practice address

451 E Altamonte Dr Ste 1279
Altamonte Springs, FL 32701-4617

Phone

(954) 846-7171

Fax

(954) 846-7170

NPI assigned

Jul 24, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Rostislav Krasnov, DDS

Title

Owner

Phone

(954) 846-7171

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Iveliss Rodriguez, DMD

  • Periodontics
  • Sunrise, FL
  • NPI 1962971200

  Dentist

  NPD (past)
• Anna Royzman, D.M.D

  • Dentist
  • Sunrise, FL
  • NPI 1962744102
  NPD (past)
• Mohamed Sirage

  • Pediatric Dentistry
  • Plantation, FL
  • NPI 1255688065
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1063768372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E ALTAMONTE DR STE 1279",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014617",
            "telephone_number": "954-846-7171",
            "fax_number": "954-846-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 E ALTAMONTE DR STE 1279",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014617",
            "telephone_number": "954-846-7171",
            "fax_number": "954-846-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMONTE MALL DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-846-7171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Altamonte Anesthesia, Inc.
• Altamonte Dental Associates, Inc
• Altamonte Eye Care, Inc
• Altamonte Family Hearing LLC
• Altamonte Internal Medicine, PA
• Altamonte Medical Associate, P.a.
• Altamonte Medical Associates PA
• Altamonte Mua Associates
• Altamonte OB GYN Assoc Clark & Perlstein MD PA
• Altamonte Oral & Maxillofacial Surgery LLC

• Dentist in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.