Kathryn Marie Daniel, D.M.D.
Individual provider Active NPI Dentist · Heathrow, FL
NPI 1104045863 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104045863
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN0012835 (FL)
- Practice address
- 120 International Pkwy
Suite #264
Heathrow, FL 32746-5031 - Phone
- (407) 333-2113
- Fax
- (407) 333-2445
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0012835 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heathrow Dental LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN0012835 | FL | Yes |
Addresses
Primary practice location
120 International Pkwy
Suite #264
Heathrow, FL 32746-5031
Mailing address
6900 S Sylvan Lake Dr
Sanford, FL 32771-9049
Phone (407) 688-0293
Other providers in Heathrow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.