NPIMap

Organization Active NPI

Kissimmee Family Dentistry, PLLC

  • General Practice Dentistry
  • Kissimmee, FL
National Provider Identifier
1407257561
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 18060 Issued in FL
Legal business name
KISSIMMEE FAMILY DENTISTRY, PLLC
Practice address
1111 Person St
Kissimmee, FL 34741-4146
Phone
(407) 870-7404
Fax
(407) 870-9960
NPI assigned
Sep 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Authorized official

Name
Dr. Patrick J Mokris, D.M.D.NPI 1487853206
Title
Owner
Phone
(407) 870-7404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN 18060 FL Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1111 Person St
Kissimmee, FL 34741-4146

Mailing address

1111 Person St
Kissimmee, FL 34741-4146
Phone (407) 870-7404

National Provider Directory

National Provider Directory

Locations

1111 Person St
Kissimmee, FL 34741
Phone (407) 870-3404

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1407257561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PERSON ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414146",
            "telephone_number": "407-870-7404",
            "fax_number": "407-870-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 PERSON ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414146",
            "telephone_number": "407-870-7404",
            "fax_number": "407-870-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISSIMMEE FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "MOKRIS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-870-7404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18060",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.