Individual provider Active NPI

German Gaitan, DDS

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1164543351
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16966 Issued in FL
Practice address
4501 S Semoran Blvd # C
Orlando, FL 32822-2407
Phone
(407) 381-3377
Fax
(407) 282-4129
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN16966 FL Primary

Addresses

Primary practice location

4501 S Semoran Blvd # C
Orlando, FL 32822-2407

Mailing address

4501 S Semoran Blvd # C
Orlando, FL 32822-2407
Phone (407) 381-3377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170913003481 FL Order and Referring Only - DentistPractitioner - Dentist 4789957762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN16966FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Four Season Dental LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164543351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S SEMORAN BLVD # C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328222407",
            "telephone_number": "407-381-3377",
            "fax_number": "407-282-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S SEMORAN BLVD # C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328222407",
            "telephone_number": "407-381-3377",
            "fax_number": "407-282-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAITAN",
        "first_name": "GERMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.