Gary Cardoso, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

DN21441 Issued in FL

Practice address

815 Cheney Hwy
Titusville, FL 32780-6960

Phone

(321) 268-0108

NPI assigned

May 28, 2014

Last updated

Sep 14, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Jan 21, 2021 through Jan 21, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lee D Tatro DDS

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  • NPI 1669597894
  NPD (past)
• Siddhi Anitha Prasanna

  dba Stellar Smile Family Dentistry

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  • NPI 1407212558
  NPD (past)
• Siddhi Anitha Prasanna PA

  • Dentist
  • Titusville, FL
  • NPI 1427330489
  NPD (past)

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1063824878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 CHENEY HWY",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806960",
            "telephone_number": "321-268-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 CHENEY HWY",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806960",
            "telephone_number": "321-268-0108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5675 N Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Cocoa Beach",
            "state": "FL",
            "postal_code": "329313988",
            "country_code": "US",
            "telephone_number": "321-783-3737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDOSO",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Caos, MD
• Deeann Capece, BA. MS
• Arnold R Capobianco, DMD
• Juan Caraballo
• Lydia Cardona
• Caremax Medical Centers of Central Florida, LLC
• Carmona Pathology Associates PA
• Pedro A Carmona, MD
• Felicia Carnahan
• Mary Elizabeth Carr-de Vries, IMH

• Dentist in Titusville, FL
• Providers in Titusville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.