NPIMap

Organization Active NPI

Deland Dental

  • Dental Clinic/Center
  • Deland, FL
National Provider Identifier
1134594617
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN15845 Issued in FL
Legal business name
DELAND DENTAL
Practice address
240 E New York Ave
Deland, FL 32724-5522
Phone
(386) 736-7309
Fax
(386) 736-7205
NPI assigned
Dec 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Dr. Carlos Medina
Title
Dentist
Phone
(386) 736-7309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN15845 FL Primary

Addresses

Primary practice location

240 E New York Ave
Deland, FL 32724-5522

Mailing address

240 E New York Ave
Deland, FL 32724-5522
Phone (386) 736-7309

National Provider Directory

National Provider Directory

Locations

240 E New York Ave
Deland, FL 32724
Phone (386) 736-7309

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1134594617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E NEW YORK AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327245522",
            "telephone_number": "386-736-7309",
            "fax_number": "386-736-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E NEW YORK AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327245522",
            "telephone_number": "386-736-7309",
            "fax_number": "386-736-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAND DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "386-736-7309",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN15845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.