Individual provider Active NPI

Kristin Paisley, DMD

  • Dentist
  • Orlando, FL
National Provider Identifier
1669921292
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN22260 Issued in FL
Practice address
8351 S John Young Pkwy
Orlando, FL 32819-9037
Phone
(407) 370-4600
Fax
(863) 679-3223
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN22260 FL Primary

Addresses

Primary practice location

8351 S John Young Pkwy
Orlando, FL 32819-9037

Mailing address

1211 Hemingway PL Apt 303
Celebration, FL 34747-5395
Phone (570) 956-4861

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
I20170123000663 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0042592362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Dental of Orlando LLC PastSince Feb 14, 2021 Accepting new patients
Comfortable Care Dental Health Professionals Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1669921292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HEMINGWAY PL APT 303",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475395",
            "telephone_number": "570-956-4861",
            "fax_number": "863-679-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8351 S JOHN YOUNG PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328199037",
            "telephone_number": "407-370-4600",
            "fax_number": "863-679-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAISLEY",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.