Carlos Alberto Soares Pires, DMD, MSD, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN20072 Issued in FL

Practice address

2225 Glenwood Dr
100
Winter Park, FL 32792-3321

Phone

(407) 647-4180

NPI assigned

Mar 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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 Oct 21, 2015 through Oct 21, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1154697704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3753 GRANDEWOOD BLVD",
            "address_2": "435",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377352",
            "telephone_number": "216-642-9111",
            "fax_number": "216-642-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 GLENWOOD DR",
            "address_2": "100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923321",
            "telephone_number": "407-647-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIRES",
        "first_name": "CARLOS ALBERTO",
        "middle_name": "SOARES",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30-022895",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN20072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.