Individual provider Active NPI

Danny K. Daccache, DMD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1376502104
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14554 Issued in FL
Practice address
4780 S Kirkman Rd
Orlando, FL 32811-3643
Phone
(407) 292-7373
Fax
(407) 292-5127
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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 DN14554 FL Primary

Addresses

Primary practice location

4780 S Kirkman Rd
Orlando, FL 32811-3643

Mailing address

926 Great Pond Dr Ste 2003
Altamonte Springs, FL 32714-7244
Phone (407) 772-5124

Other identifiers 1

IdentifierTypeStateIssuer
001038200MedicaidFL

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
I20150529000764 FL Order and Referring Only - DentistPractitioner - Dentist 0547580706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1376502104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 GREAT POND DR STE 2003",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147244",
            "telephone_number": "407-772-5124",
            "fax_number": "407-788-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 S KIRKMAN RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328113643",
            "telephone_number": "407-292-7373",
            "fax_number": "407-292-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACCACHE",
        "first_name": "DANNY",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001038200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.