Individual provider Active NPI

Derek Alan Slosser, D.M.D

  • Endodontics
  • Orlando, FL
National Provider Identifier
1609805357
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN 14665 Issued in FL
Practice address
430 N Mills Ave
Suite 2
Orlando, FL 32803-5746
Phone
(407) 843-8180
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 13483 MD
Endodontics 1223E0200X DN 14665 FL Primary

Addresses

Primary practice location

430 N Mills Ave
Suite 2
Orlando, FL 32803-5746

Mailing address

430 N Mills Ave
Suite 2
Orlando, FL 32803-5746
Phone (407) 843-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20180314001543 VA Order and Referring Only - DentistPractitioner - Dentist 5395007199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 14665FLMDEndodontist
13483MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1609805357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N MILLS AVE",
            "address_2": "SUITE 2",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035746",
            "telephone_number": "407-843-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N MILLS AVE",
            "address_2": "SUITE 2",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035746",
            "telephone_number": "407-843-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOSSER",
        "first_name": "DEREK",
        "middle_name": "ALAN",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "13483",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN 14665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.