Individual provider Active NPI

Marcela D Guzman, DDS

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1124296256
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16736 Issued in FL
Practice address
10045 Oakside CT
Orlando, FL 32836-5938
Phone
(407) 370-3236
NPI assigned
Feb 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN16736 FL Primary

Addresses

Primary practice location

10045 Oakside CT
Orlando, FL 32836-5938

Mailing address

1014 Buenaventura Blvd
Kissimmee, FL 34743-7865
Phone (407) 344-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519002029 FL Order and Referring Only - DentistPractitioner - Dentist 3779872494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Dental LLC General Practice Past Accepting new patients
Hallmark Dental Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1124296256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BUENAVENTURA BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347437865",
            "telephone_number": "407-344-2400",
            "fax_number": "407-344-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 OAKSIDE CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365938",
            "telephone_number": "407-370-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "MARCELA",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.