Active NPI
Mena Shenouda
- Dentist
- Kissimmee, FL
National Provider Identifier
1316430796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN23464
- Practice address
- 2907 Vineland Rd
Kissimmee, FL 34746-5505 - Phone
- (407) 396-1288
- NPI assigned
- Jun 11, 2018
- Last updated
- Jun 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN23464 | FL | Primary |
Addresses
Primary practice location
2907 Vineland Rd
Kissimmee, FL 34746-5505
Mailing address
9656 Avellino Ave Unit 7102
Orlando, FL 32819-8861
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180731001731 | FL | Order and Referring Only - Dentist | 7012265515 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coast Florida P.a. | Dentist | Past | Accepting new patients |
| Coast Florida P.a. | Dentist | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Tampa, FL
- NPI 1730287673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1316430796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9656 AVELLINO AVE UNIT 7102",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328198861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2907 VINELAND RD",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347465505",
"telephone_number": "407-396-1288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENOUDA",
"first_name": "MENA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN23464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
- Judith Ann Shell, R.N.,PHD
- Sheila Margaret Shell
- Jamie M Shellenberger, PT
- Diane Shelton, MS SPECIAL ED
- Mary Shenouda, DDS
- Michael Sherfield, SLPA
- Sheridan Healthcorp Inc
- Sheridan Radiology Services of Central Florida Inc
- Sheridan Radiology Services of Central Florida, Inc
- Sheridan Radiology Services of Central Florida, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.