Dentistry of Kissimmee

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DENTISTRY OF KISSIMMEE

Practice address

2721 Michigan Ave
Kissimmee, FL 34744-1551

Phone

(407) 847-0111

NPI assigned

Dec 9, 2024

Organization subpart

No

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

Authorized official

Name

Daniel Jimenez

Title

Chief Operating Officer

Phone

(407) 529-6814

Specialties & licenses 1

Addresses

Tax ID family

Stride Dental Hub LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stride Dental Hub LLC

  • General Practice Dentistry
  • Sanford, FL
  • NPI 1104610617
  NPD tax ID

Locations

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1447066097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11063 MOBBERLEY CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326965",
            "telephone_number": "407-312-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 MICHIGAN AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441551",
            "telephone_number": "407-847-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY OF KISSIMMEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-529-6814"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael R Denardis, DO
• Sandra I Deniz, MD
• Madison Leigh Dennis
• Jessica Denobrega
• Dental Elements, PA
• Dentists of Kissimmee, PA
• Dependable Attentive Home Care LLC
• Mara-Joanne Derinor, DNP, PMHNP-BC
• Ajay Krishna Desai
• Deesha Desai, MD

• Dentist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.