Ideal Dental of Clermont PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IDEAL DENTAL OF CLERMONT PLLC

Practice address

2612 S Hwy 27 Ste 600
Clermont, FL 34711-6521

Phone

(407) 965-0090

NPI assigned

Aug 17, 2020

Organization subpart

No

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

Authorized official

Name

Joshua Coussa, DMD

Title

Owner

Phone

(972) 331-8079

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evandro Luiz Garcia Da Silva

  • General Practice Dentistry
  • Clermont, FL
  • NPI 1871479998
  NPD
• Richard Alexandro Bustamante, DMD

  • Dentist
  • Clermont, FL
  • NPI 1043065121
  NPD (past)

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1568074193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840925",
            "telephone_number": "972-361-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 S HWY 27 STE 600",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116521",
            "telephone_number": "407-965-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL OF CLERMONT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "COUSSA",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-331-8079",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eden Hazira Hussin-Biswas, DDS
• Dwight Hutchinson, B.S
• Isabelle Annalise Hutchinson
• Bao L Huynh, MD
• Michelle Hylton, ARNP
• Ielevate Wellness LLC
• Implagraft LLC
• In Via Behavioral Health LLC
• In-Home Therapy of Central Florida Inc
• Indian Shore Manor, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.