Active NPI
Trenton Mandato, DMD
- Dentist
- Port Orange, FL
National Provider Identifier
1275428815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30386
- Practice address
- 1765 Dunlawton Ave
Port Orange, FL 32127-4717 - Phone
- (386) 259-3905
- NPI assigned
- Jun 12, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30386 | FL | Primary |
Addresses
Primary practice location
1765 Dunlawton Ave
Port Orange, FL 32127-4717
Mailing address
1875 Brooks LN
Oviedo, FL 32765-8632
Phone (407) 367-9566
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30386 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749686400000",
"number": "1275428815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1875 BROOKS LN",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327658632",
"telephone_number": "407-367-9566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 DUNLAWTON AVE",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321274717",
"telephone_number": "386-259-3905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDATO",
"first_name": "TRENTON",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-12",
"last_updated": "2025-06-12",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "30386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.