Individual provider Active NPI

Sandra S Wasif, DDS

  • Public Health Dentistry
  • Oviedo, FL
National Provider Identifier
1306811187
Registry record updated May 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DN15762 Issued in FL
Practice address
100 Burnsed PL
Suite 1000
Oviedo, FL 32765-6695
Phone
(407) 366-9090
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DN15762 FL Primary
Dentist 122300000X DN15762 FL

Addresses

Primary practice location

100 Burnsed PL
Suite 1000
Oviedo, FL 32765-6695

Mailing address

100 Burnsed PL
Suite 1000
Oviedo, FL 32765-6695
Phone (407) 366-9090

Other identifiers 2

IdentifierTypeStateIssuer
075214200MedicaidFL
001347951OtherFLNPI

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
DN15762FLMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401062400000",
    "number": "1306811187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BURNSED PL",
            "address_2": "SUITE 1000",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656695",
            "telephone_number": "407-366-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BURNSED PL",
            "address_2": "SUITE 1000",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656695",
            "telephone_number": "407-366-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIF",
        "first_name": "SANDRA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2014-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN15762",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15762",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075214200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "001347951",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2014; 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.