Active NPI
Luis A. Espinet, D.M.D.
- Dentist
- Lake Mary, FL
National Provider Identifier
1104921972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN14288
- Practice address
- 2500 W Lake Mary Blvd
#106
Lake Mary, FL 32746-3501 - Phone
- (407) 328-6411
- Fax
- (407) 328-6444
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN14288 | FL | Primary |
| General Practice Dentistry | 1223G0001X | DN14288 | FL | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2240 | PR |
Addresses
Primary practice location
2500 W Lake Mary Blvd
#106
Lake Mary, FL 32746-3501
Mailing address
2500 W.Lake Mary Bivd.
#106
Lake Mary, FL 32746
Phone (407) 328-6411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170526000649 | PR | Order and Referring Only - Oral Surgery | 6204103088 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2240 | PR | MD | Clinical Child & Adolescent Psychologist |
| DN14288 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275523200000",
"number": "1104921972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 W.LAKE MARY BIVD.",
"address_2": "#106",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "32746",
"telephone_number": "407-328-6411",
"fax_number": "407-328-6444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 W LAKE MARY BLVD",
"address_2": "#106",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327463501",
"telephone_number": "407-328-6411",
"fax_number": "407-328-6444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPINET",
"first_name": "LUIS",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2010-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN14288",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN14288",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PR",
"license": "2240",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.