Stephanie M Lacquaniti, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17576 Issued in FL

Practice address

18170 US Highway 441
Mount Dora, FL 32757-6709

Phone

(352) 383-8121

Fax

(352) 383-8183

NPI assigned

Mar 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578680146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18170 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576709",
            "telephone_number": "352-383-8121",
            "fax_number": "352-383-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18170 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576709",
            "telephone_number": "352-383-8121",
            "fax_number": "352-383-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACQUANITI",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "17576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley B Kreisher
• Kenneth David Kronhaus, MD
• Caroline Elizabeth Krueger, D.M.D.
• Karen S Kyle, OTR/L
• Dukens Labaze, M.D.
• Lake Cardiology PA
• Lake County Adult Activity Center Inc
• Lake Emergency Medical Services, Inc.
• Lake Pediatrics P. a.
• Lake Pediatrics P. a.

• General Practice Dentistry in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.