Individual provider Active NPI

Dayanne Georges Ghorayeb, DMD

  • General Practice Dentistry
  • Lutz, FL
National Provider Identifier
1518642016
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN28064 Issued in FL
Practice address
19721 State Road 54
Lutz, FL 33558-7807
Phone
(813) 435-3462
NPI assigned
Jun 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN28064 FL Primary

Addresses

Primary practice location

19721 State Road 54
Lutz, FL 33558-7807

Mailing address

15424 E Pond Woods Dr
Tampa, FL 33618-1807
Phone (813) 389-1732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN28064FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1518642016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15424 E POND WOODS DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181807",
            "telephone_number": "813-389-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19721 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335587807",
            "telephone_number": "813-435-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHORAYEB",
        "first_name": "DAYANNE",
        "middle_name": "GEORGES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.