Individual provider Active NPI

Mary Lynn Verardi, D.D.S.

  • General Practice Dentistry
  • Lake Mary, FL
National Provider Identifier
1417903485
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16615 Issued in FL
Practice address
917 Rinehart Rd
Suite 2021
Lake Mary, FL 32746-4802
Phone
(407) 688-9901
Fax
(407) 688-9902
NPI assigned
May 25, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 16615 FL Primary

Addresses

Primary practice location

917 Rinehart Rd
Suite 2021
Lake Mary, FL 32746-4802

Mailing address

917 Rinehart Rd
Suite 2021
Lake Mary, FL 32746-4802
Phone (407) 688-9901

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
I20160425001249 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1658670799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16615FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Verardi Dental General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417903485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 RINEHART RD",
            "address_2": "SUITE 2021",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464802",
            "telephone_number": "407-688-9901",
            "fax_number": "407-688-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 RINEHART RD",
            "address_2": "SUITE 2021",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464802",
            "telephone_number": "407-688-9901",
            "fax_number": "407-688-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERARDI",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "16615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.