Active NPI
David R Sterrett, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Kissimmee, FL
National Provider Identifier
1457589228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DN 20364
- Practice address
- 1379 E Vine St
Kissimmee, FL 34744-3603 - Phone
- (407) 933-8686
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.027935 | IL | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DN 20364 | FL | Primary |
Addresses
Primary practice location
1379 E Vine St
Kissimmee, FL 34744-3603
Mailing address
5817 Bromelia CT
Naples, FL 34119-4797
Phone (973) 652-0853
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150604002217 | FL | Order and Referring Only - Oral Surgery | 9931420718 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.027935 | IL | MD | Dentist |
| DN 20364 | FL | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health, Inc. | Current | Accepting new patients |
Interoperability endpoints
- dsterrett179051@orlandohealth.medalliesdirect.net
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.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379289600000",
"number": "1457589228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5817 BROMELIA CT",
"city": "NAPLES",
"state": "FL",
"postal_code": "341194797",
"telephone_number": "973-652-0853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1379 E VINE ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347443603",
"telephone_number": "407-933-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERRETT",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2013-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.027935",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "FL",
"license": "DN 20364",
"primary": true
}
],
"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 Sep 16, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.