Mai Eltantawy, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN27993 Issued in FL

Practice address

12851 Narcoossee Rd Ste 102
Orlando, FL 32832-7156

Phone

(407) 749-1560

NPI assigned

Jul 28, 2023

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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 and National Provider Directory roles.

• Ideal Dental of Lake Nona PLLC

  • Dentist
  • Orlando, FL
  • NPI 1821609454

  General Practice

  NPD

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1144901463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17804 SW 35TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330291673",
            "telephone_number": "954-651-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12851 NARCOOSSEE RD STE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328327156",
            "telephone_number": "407-749-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTANTAWY",
        "first_name": "MAI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN27993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Elsea
• Deema Elshalaby
• Christopher Elstermann
• Jacquita Elston
• Elsy LLC
• Cheryl Elwell, PT
• Kathleen Anne Elwell
• Nancy Elwood, CRNA
• Katie Evers Elzer, RD, LD/N
• Alexis Emad

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, 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 Sep 12, 2023; 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.