Individual provider Active NPI

Edward Henry Lombana-Cano, DMD

  • General Practice Dentistry
  • Kissimmee, FL
National Provider Identifier
1306198619
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19947 Issued in FL
Practice address
1096 Cypress Pkwy
Kissimmee, FL 34759-3328
Phone
(407) 933-8222
Fax
(407) 933-6964
NPI assigned
Oct 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19947 FL Primary

Addresses

Primary practice location

1096 Cypress Pkwy
Kissimmee, FL 34759-3328

Mailing address

2729 Maderia Cir
Melbourne, FL 32935-5594
Phone (321) 298-3803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20150526001549 FL Order and Referring Only - DentistPractitioner - Dentist 3577883909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19947FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1306198619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 MADERIA CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355594",
            "telephone_number": "321-298-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 CYPRESS PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593328",
            "telephone_number": "407-933-8222",
            "fax_number": "407-933-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBANA-CANO",
        "first_name": "EDWARD",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-10",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "19947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.