Individual provider Active NPI

Alexander Raiken, D.M.D.

  • Endodontics
  • Orlando, FL
National Provider Identifier
1629520341
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22348 Issued in FL
Practice address
899 N Orange Ave Apt 501
Orlando, FL 32801
Phone
(610) 209-3768
NPI assigned
Oct 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 22348 FL Primary

Addresses

Primary practice location

899 N Orange Ave Apt 501
Orlando, FL 32801

Mailing address

5930 SW 24TH PL
Apt. 306
Davie, FL 33314-1163
Phone (610) 209-3768

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
I20181109000463 FL Order and Referring Only - DentistPractitioner - Dentist 3779837745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22348FLMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1629520341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 SW 24TH PL",
            "address_2": "APT. 306",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141163",
            "telephone_number": "610-209-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 N ORANGE AVE APT 501",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32801",
            "telephone_number": "610-209-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIKEN",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-28",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "22348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.