Individual provider Active NPI

Andres J. Seoane, DMD

  • General Practice Dentistry
  • Kissimmee, FL
National Provider Identifier
1356722581
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 21274 Issued in FL
Practice address
1096 Cypress Pkwy
Kissimmee, FL 34759-3328
Phone
(407) 933-8222
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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 DN 21274 FL Primary

Addresses

Primary practice location

1096 Cypress Pkwy
Kissimmee, FL 34759-3328

Mailing address

1096 Cypress Pkwy
Kissimmee, FL 34759-3328

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
I20150702000218 FL Order and Referring Only - DentistPractitioner - Dentist 1355653452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21274FLMDGeneral 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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1356722581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 CYPRESS PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593328"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEOANE",
        "first_name": "ANDRES",
        "middle_name": "J.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.