Individual provider Active NPI

Laurie Lenee Harrell, DMD

  • Pediatric Dentistry
  • Altamonte Springs, FL
National Provider Identifier
1568625846
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN18391 Issued in FL
Practice address
926 Great Pond Dr Ste 1000
Altamonte Springs, FL 32714-7244
Phone
(407) 862-0444
Fax
(407) 862-2771
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN18391 FL Primary

Addresses

Primary practice location

926 Great Pond Dr Ste 1000
Altamonte Springs, FL 32714-7244

Mailing address

100 S Eola Dr Unit 1710
Orlando, FL 32801-6602

Other identifiers 1

IdentifierTypeStateIssuer
000323300MedicaidFL

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
DN18391FLMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1568625846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S EOLA DR UNIT 1710",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328016602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 GREAT POND DR STE 1000",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147244",
            "telephone_number": "407-862-0444",
            "fax_number": "407-862-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "LAURIE",
        "middle_name": "LENEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN18391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000323300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

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