Lake Buena Vista Dental P.a.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKE BUENA VISTA DENTAL P.A.

Practice address

12131 S. Apopka-Vineland Road
Orlando, FL 32801

Phone

(407) 239-8883

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Mike Cole

Title

Insurance Director

Phone

(727) 726-1611

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366566903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12131 S. APOPKA-VINELAND ROAD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12131 S. APOPKA-VINELAND ROAD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32801",
            "telephone_number": "407-239-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE BUENA VISTA DENTAL P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakay Family Support Services, LLC
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• Lake Baldwin Dental of Orlando PLLC
• Lake Baldwin Dental PA
• Lake Buena Vista Chiropractic PA
• Lake Buena Vista Pharmacy LLC
• Lake Conway Urgent Care LLC
• Lake Ellenor Medical Center LLC
• Lake Eola Dental, Inc.
• Lake Family Practice

• Dentist in Orlando, FL
• Providers in Orlando, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.