Individual provider Active NPI

Latoya Legrand Rolle, DDS

  • Pediatric Dentistry
  • Orlando, FL
National Provider Identifier
1386097343
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN26398 Issued in FL
Practice address
12964 Narcoossee Rd
Orlando, FL 32832-6925
Phone
(407) 627-1234
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN26398 FL Primary

Addresses

Primary practice location

12964 Narcoossee Rd
Orlando, FL 32832-6925

Mailing address

12964 Narcoossee Rd
Orlando, FL 32832-6925
Phone (407) 627-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20170330001394 TN Order and Referring Only - DentistPractitioner - Dentist 6204111461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN26398FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bethel Burris Oliver PLLC Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1386097343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12964 NARCOOSSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326925",
            "telephone_number": "407-627-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12964 NARCOOSSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326925",
            "telephone_number": "407-627-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLE",
        "first_name": "LATOYA",
        "middle_name": "LEGRAND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2021-09-20",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN26398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.