Individual provider Active NPI

Ramez Fidy, DMD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1629362686
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 19348 Issued in FL
Practice address
8204 Crystal Clear LN Ste 600
Orlando, FL 32809-7755
Phone
(407) 239-0126
Fax
(407) 239-0127
NPI assigned
Jun 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 19348 FL Primary

Addresses

Primary practice location

8204 Crystal Clear LN Ste 600
Orlando, FL 32809-7755

Mailing address

55 W Church St
Apt 2417
Orlando, FL 32801-4931

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150602002387 FL Order and Referring Only - DentistPractitioner - Dentist 2567783541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 19348FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1629362686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W CHURCH ST",
            "address_2": "APT 2417",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328014931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 CRYSTAL CLEAR LN STE 600",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097755",
            "telephone_number": "407-239-0126",
            "fax_number": "407-239-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDY",
        "first_name": "RAMEZ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 19348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.