Individual provider Active NPI

Carla Patricia Talavera-Jordan, D.M.D.

  • Dentist
  • Windermere, FL
National Provider Identifier
1295748747
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 16454 Issued in FL
Practice address
12963 Overstreet Rd
Windermere, FL 34786-6643
Phone
(407) 574-7370
Fax
(407) 574-7370
NPI assigned
Aug 15, 2006
Sex
Female
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
Dentist 122300000X DN 16454 FL Primary

Addresses

Primary practice location

12963 Overstreet Rd
Windermere, FL 34786-6643

Mailing address

12963 Overstreet Rd
Windermere, FL 34786-6643
Phone (407) 574-7370

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
DN 16454FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295748747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12963 OVERSTREET RD",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866643",
            "telephone_number": "407-574-7370",
            "fax_number": "407-574-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12963 OVERSTREET RD",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866643",
            "telephone_number": "407-574-7370",
            "fax_number": "407-574-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALAVERA-JORDAN",
        "first_name": "CARLA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 16454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.