Individual provider Active NPI

Ruben Borrero-Serrano, DMD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1285630376
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN12272 Issued in FL
Practice address
4250 Town Center Blvd
Orlando, FL 32837-6192
Phone
(407) 856-0208
Fax
(407) 856-8113
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 841 PR
General Practice Dentistry 1223G0001X DN12272 FL Primary

Addresses

Primary practice location

4250 Town Center Blvd
Orlando, FL 32837-6192

Mailing address

3833 Brookmyra Dr
Orlando, FL 32837-5103
Phone (407) 856-0208

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

LicenseStateTypeSpecialty
841PRMDChiropractor
DN12272FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dentistry & Dental Specialists Group Past Accepting new patients

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1285630376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 BROOKMYRA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328375103",
            "telephone_number": "407-856-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 TOWN CENTER BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376192",
            "telephone_number": "407-856-0208",
            "fax_number": "407-856-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRERO-SERRANO",
        "first_name": "RUBEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "841",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.