Dentist of Lake Mary LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DENTIST OF LAKE MARY LLC

Practice address

229 Wheelhouse LN Ste 1241
Lake Mary, FL 32746-3665

Phone

(407) 284-1645

NPI assigned

Nov 25, 2020

Organization subpart

No

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

Authorized official

Name

Dharam Pal Tayal, DDS

Title

Member

Phone

(716) 239-5889

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1124622659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12250 STRATEGY BLVD STE 437",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328172108",
            "telephone_number": "407-284-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 WHEELHOUSE LN STE 1241",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463665",
            "telephone_number": "407-284-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTIST OF LAKE MARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "TAYAL",
        "authorized_official_first_name": "DHARAM",
        "authorized_official_middle_name": "PAL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "716-239-5889",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Denham
• Erin Marie Dennihan, PT, MPT
• Dasha Shandral Dennis
• Stephen Randall Denny, PA
• Dental Associates of Lake Mary, P.a
• Dermacare Senior Solutions LLC
• Gabriella Yolanda Desantis
• Karen Desir, APRN
• Mercedes Despaigne
• Pamela Dewitt

• Dentist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.