Individual provider Active NPI

Alex David Parra Meneses

  • General Practice Dentistry
  • Kissimmee, FL
National Provider Identifier
1629831029
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN29629 Issued in FL
Practice address
109 N Doverplum Ave
Kissimmee, FL 34758-3309
Phone
(407) 943-8600
Fax
(407) 932-5153
NPI assigned
Jan 30, 2024
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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 DN29629 FL Primary

Addresses

Primary practice location

109 N Doverplum Ave
Kissimmee, FL 34758-3309

Mailing address

1503 Bill Beck Blvd
Kissimmee, FL 34744-9516
Phone (407) 943-8600

Other practice location 1

5425 S Semoran Blvd Ste 5A
Orlando, FL 32822-1777
Phone (617) 358-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN29629FLMDGeneral 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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1629831029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 BILL BECK BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347449516",
            "telephone_number": "407-943-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N DOVERPLUM AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347583309",
            "telephone_number": "407-943-8600",
            "fax_number": "407-932-5153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5425 S Semoran Blvd Ste 5A",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328221777",
            "country_code": "US",
            "telephone_number": "617-358-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARRA MENESES",
        "first_name": "ALEX",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.