Hector L Briceno, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN15539 Issued in FL

Practice address

12200 W Colonial Dr
Suite 103
Winter Garden, FL 34787-4125

Phone

(407) 656-9455

Fax

(407) 656-6145

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

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.

• Oral Surgery Center of West Orlando

  • Oral and Maxillofacial Surgery (Dentist)
  • Winter Garden, FL
  • NPI 1588878441
  NPD (past) Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265568208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 W COLONIAL DR",
            "address_2": "SUITE 103",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874125",
            "telephone_number": "407-656-9455",
            "fax_number": "407-656-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 W COLONIAL DR",
            "address_2": "SUITE 103",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874125",
            "telephone_number": "407-656-9455",
            "fax_number": "407-656-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICENO",
        "first_name": "HECTOR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN15539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lucimara Brant Pessoa Mello
• Heidi Marie Brewton
• Bright Hearts Behavior LLC
• Bright Horizons Behavioral Services LLC
• Bright Path Wellness
• Brightstar FL/Al Operations, LLC (BrightStar Care of SW Orlando)
• Brightstart Pediatrics, LLC

• Oral and Maxillofacial Surgery (Dentist) in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.