Individual provider Active NPI

Sondra Lavelle Avant, D.D.S., M.S.

  • Endodontics
  • Port Orange, FL
National Provider Identifier
1437286663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN13606 Issued in FL
Practice address
731 Dunlawton Ave Ste 105
Port Orange, FL 32127-4237
Phone
(386) 304-4620
Fax
(386) 304-4618
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN13606 FL Primary

Addresses

Primary practice location

731 Dunlawton Ave Ste 105
Port Orange, FL 32127-4237

Mailing address

731 Dunlawton Ave Ste 105
Port Orange, FL 32127-4237
Phone (386) 304-4620

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
I20161202001295 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3577843069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Sondra L Avant DDS Ms PA Endodontics PastSince Jun 15, 1995 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437286663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 DUNLAWTON AVE STE 105",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274237",
            "telephone_number": "386-304-4620",
            "fax_number": "386-304-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 DUNLAWTON AVE STE 105",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274237",
            "telephone_number": "386-304-4620",
            "fax_number": "386-304-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVANT",
        "first_name": "SONDRA",
        "middle_name": "LAVELLE",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.