Individual provider Active NPI

Alan Bruce Kingston, DMD

  • Dentist
  • Altamonte Springs, FL
National Provider Identifier
1376719203
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7139 Issued in FL
Practice address
101 Willow Ave
Altamonte Springs, FL 32714-2104
Phone
(407) 862-1211
Fax
(407) 862-5359
NPI assigned
Apr 30, 2008
Last updated
Apr 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7139 FL Primary

Addresses

Primary practice location

101 Willow Ave
Altamonte Springs, FL 32714-2104

Mailing address

101 Willow Ave
Altamonte Springs, FL 32714-2104
Phone (407) 862-1211

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
I20160225000137 FL Order and Referring Only - DentistPractitioner - Dentist 1153626486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7139FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1376719203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLOW AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142104",
            "telephone_number": "407-862-1211",
            "fax_number": "407-862-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLOW AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142104",
            "telephone_number": "407-862-1211",
            "fax_number": "407-862-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSTON",
        "first_name": "ALAN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "7139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.