Omar Ata, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9967 Issued in FL

Practice address

3192 S John Young Pkwy
Suite B
Kissimmee, FL 34746-6546

Phone

(407) 870-5151

Fax

(407) 870-2556

NPI assigned

Apr 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 28, 2015 through Dec 28, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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

• Omar Ata, D.D.S., PA.

  • General Practice Dentistry
  • Kissimmee, FL
  • NPI 1447215876
  NPD (past) Authorized official
• Ata Dental Kissimmee LLC

  • General Practice Dentistry
  • Kissimmee, FL
  • NPI 1366001471
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144285586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3192 S JOHN YOUNG PKWY",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466546",
            "telephone_number": "407-870-5151",
            "fax_number": "407-870-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3192 S JOHN YOUNG PKWY",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466546",
            "telephone_number": "407-870-5151",
            "fax_number": "407-870-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATA",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "9967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• At Home Companion of Florida, Inc.
• At Talitha Cumi Home Care, Inc.
• Ata Dental Kissimmee LLC
• Jill Edwards Ata, D.M.D
• Joseph Adam Ata, D.M.D.
• Tahsina Y Atiquzzaman, M.D.
• Tatyana Atkins
• Atlantic Professional Center Inc
• Peter Lyndell Atuel, RPT
• Atza Swicht Transportation Corp

• General Practice Dentistry in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.