West Orange Dental Group LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

DN16856 Issued in FL

Legal business name

WEST ORANGE DENTAL GROUP LLC

Practice address

217 N Kirkman Rd
Suite 3
Orlando, FL 32811-1186

Phone

(407) 290-9588

NPI assigned

Jan 24, 2013

Organization subpart

No

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

Authorized official

Name

Tejumade St Matthew-Daniels, DMD

Title

Owner

Phone

(409) 290-9588

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1508104654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N KIRKMAN RD",
            "address_2": "SUITE 3",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328111186",
            "telephone_number": "407-290-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N KIRKMAN RD",
            "address_2": "SUITE 3",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328111186",
            "telephone_number": "407-290-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ORANGE DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "ST MATTHEW-DANIELS",
        "authorized_official_first_name": "TEJUMADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-290-9588",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "DN16856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• West Orange Dental Group, LLC
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• West Orange Orlando Dialysis Center, LLC (Fresenius Kidney Care South Orlando)
• West Orange Speech Pathologist Inc.
• West Orange Speech Pathologist, Inc.

• Health Maintenance Organization in Orlando, FL
• Providers in Orlando, FL by specialty
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.