Individual provider Active NPI

Mary Elizabeth Hunter, DDS

  • Dentist
  • Winter Garden, FL
National Provider Identifier
1154501633
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23934 Issued in FL
Practice address
10658 Avalon Rd Ste 100
Winter Garden, FL 34787-6953
Phone
(407) 347-4071
Fax
(407) 395-4022
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30022609 OH
General Practice Dentistry 1223G0001X 30022609 OH
Dentist 122300000X DN23934 FL Primary

Addresses

Primary practice location

10658 Avalon Rd Ste 100
Winter Garden, FL 34787-6953

Mailing address

14747 Black Cherry TRL
Winter Garden, FL 34787-6275
Phone (513) 515-1634

Other names 1

  • Mary Elizabeth Cliett Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN23934FLMDDentist
30022609OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals. P.a. General Practice CurrentSince Jun 16, 2024 Accepting new patients
Pinnacle One Dental Group General Practice Past Accepting new patients

Locations

10658 Avalon Rd
Ste 100
Winter Garden, FL 34787
Phone (407) 347-4071

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": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1154501633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14747 BLACK CHERRY TRL",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876275",
            "telephone_number": "513-515-1634",
            "fax_number": "407-395-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10658 AVALON RD STE 100",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876953",
            "telephone_number": "407-347-4071",
            "fax_number": "407-395-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30022609",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022609",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CLIETT",
            "middle_name": "ELIZABETH",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.