Joseph Adam Ata, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN18559 Issued in FL

Practice address

3291 S John Young Parkway
Suite B
Kissimmee, FL 34746

Phone

(407) 870-5151

Fax

(407) 870-2556

NPI assigned

May 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 23, 2015 through Dec 23, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1457585242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 S JOHN YOUNG PARKWAY",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34746",
            "telephone_number": "407-870-5151",
            "fax_number": "407-870-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 S JOHN YOUNG PARKWAY",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34746",
            "telephone_number": "407-870-5151",
            "fax_number": "407-870-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATA",
        "first_name": "JOSEPH",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tahsina Y Atiquzzaman, M.D.
• Tatyana Atkins
• Atlantic Professional Center Inc
• Peter Lyndell Atuel, RPT

• 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 May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.