St. Luke'S Family Dentistry, P.a.

Primary specialty

DentistTaxonomy code 122300000X

License

DN15762 Issued in FL

Legal business name

ST. LUKE'S FAMILY DENTISTRY, P.A.

Practice address

100 Burnsed PL
Suite 1000
Oviedo, FL 32765-6695

Phone

(407) 366-9090

NPI assigned

Sep 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Sandra Wasif, DDS

Title

Owner

Phone

(407) 366-9090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1629328620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BURNSED PL",
            "address_2": "SUITE 1000",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656695",
            "telephone_number": "407-366-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BURNSED PL",
            "address_2": "SUITE 1000",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656695",
            "telephone_number": "407-366-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S FAMILY DENTISTRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "WASIF",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-366-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlei Jo Spitale
• Michelle Nicole Spivey, COTA/L
• Ashley Squillante
• Vishaka Sridhar, OTR
• Jesse St John, PHARMD
• Kailey Marie Stabile, MA CCC-SLP
• Sharon C Stacey, O.T. R.
• Stacy Taylor, Inc.
• Julia Stafford, RBT
• Tammy R Stafford, ED.D., A/OGA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.