Individual provider Active NPI

Juliana P. Bermudez, D.D.S.

  • General Practice Dentistry
  • Altamonte Springs, FL
National Provider Identifier
1306159165
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18862 Issued in FL
Practice address
851 W State Road 436
Suite 1021
Altamonte Springs, FL 32714-3000
Phone
(407) 786-5559
Fax
(407) 786-5554
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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 0401418134 VA
General Practice Dentistry 1223G0001X DN18862 FL Primary

Addresses

Primary practice location

851 W State Road 436
Suite 1021
Altamonte Springs, FL 32714-3000

Mailing address

11332 Headlands CT
Reston, VA 20191-3636
Phone (909) 533-1976

Other practice location 1

21 Loudoun St SE
Leesburg, VA 20175-3012
Phone (703) 777-4443

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
DN18862FLMDGeneral Practice Dentistry
0401418134VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Dental General Practice Past Accepting new patients
Vida Asiamah DDS PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1306159165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11332 HEADLANDS CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913636",
            "telephone_number": "909-533-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 W STATE ROAD 436",
            "address_2": "SUITE 1021",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143000",
            "telephone_number": "407-786-5559",
            "fax_number": "407-786-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Loudoun St SE",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201753012",
            "country_code": "US",
            "telephone_number": "703-777-4443",
            "fax_number": "703-373-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "JULIANA",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418134",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.