Active NPI
Quinta Idiare, DMD
- General Practice Dentistry
- Lady Lake, FL
National Provider Identifier
1669766978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19341
- Practice address
- 560 N US Highway 27 # 441
Lady Lake, FL 32159-3776 - Phone
- (352) 259-1065
- Fax
- (352) 259-5774
- NPI assigned
- Jun 3, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19341 | FL | Primary |
Addresses
Primary practice location
560 N US Highway 27 # 441
Lady Lake, FL 32159-3776
Mailing address
281 Sanders Creek Pkwy
East Syracuse, NY 13057-1307
Phone (315) 454-6000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19341 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pimendent, PA | General Practice | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Lady Lake, FL
- NPI 1093062630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307059200000",
"number": "1669766978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 SANDERS CREEK PKWY",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130571307",
"telephone_number": "315-454-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 N US HIGHWAY 27 # 441",
"city": "LADY LAKE",
"state": "FL",
"postal_code": "321593776",
"telephone_number": "352-259-1065",
"fax_number": "352-259-5774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDIARE",
"first_name": "QUINTA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-03",
"last_updated": "2011-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "19341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lady Lake, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.