Ricardo Carlo Carrillo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23339 Issued in FL

Practice address

1993 Daniels Rd Ste 120
Winter Garden, FL 34787-4598

Phone

(407) 395-9335

NPI assigned

May 11, 2016

Last updated

Jan 11, 2021By the provider in NPPES

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

Other identifiers 1

Other names 1

• Ricardo Carlo Carrillo Giraldo Former name

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

Medicare enrollment (NPD)

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

• Smilexp PLLC

  dba The Smile Home

  • Dental Clinic/Center
  • Winter Garden, FL
  • NPI 1770106411
  NPD Authorized official

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1174979991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 DANIELS RD STE 120",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874598",
            "telephone_number": "703-341-7769",
            "fax_number": "407-395-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 DANIELS RD STE 120",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874598",
            "telephone_number": "407-395-9335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 W DeSoto St",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "34711",
            "country_code": "US",
            "telephone_number": "352-394-3071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "RICARDO",
        "middle_name": "CARLO",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "23339",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "1507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174979991",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICARDO",
            "last_name": "CARRILLO GIRALDO",
            "middle_name": "CARLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stacy Lynn Carmichael, PH.D.
• Ana Paula Carocha Jalkh, MD
• Rosalin A Carranza, PHARM D
• Zulmarie Lynn Carrasquillo del Valle, PHARMD
• Amy Carrillo
• Tonya Lorene Carson, MS, CCC-SLP
• Alena Carswell
• Brittini Carter, LMHC
• Rose M Carter
• Tanisha Carter

• General Practice Dentistry in Winter Garden, FL
• Providers in Winter Garden, 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 Jan 11, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.