Individual provider Active NPI

Cheryl Lynn Pisano, DMD

  • Dentist
  • Lady Lake, FL
National Provider Identifier
1154630341
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN17274 Issued in FL
Practice address
8575 NE 138TH LN Ste 105
Lady Lake, FL 32159-8996
Phone
(352) 364-0064
Fax
(352) 364-0065
NPI assigned
Oct 5, 2010
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN17274 FL Primary

Addresses

Primary practice location

8575 NE 138TH LN Ste 105
Lady Lake, FL 32159-8996

Mailing address

8575 NE 138TH LN Ste 105
Lady Lake, FL 32159-8996
Phone (352) 364-0064

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
DN17274FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dunnellon Dentistry PastSince Nov 12, 2016 Accepting new patients
Cnjuenger PastSince Oct 21, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1154630341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 NE 138TH LN STE 105",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598996",
            "telephone_number": "352-364-0064",
            "fax_number": "352-364-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 NE 138TH LN STE 105",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598996",
            "telephone_number": "352-364-0064",
            "fax_number": "352-364-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANO",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.