Individual provider Active NPI

Connie C. L. Feng, DMD

  • General Practice Dentistry
  • Altamonte Springs, FL
National Provider Identifier
1689057432
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 21317 Issued in FL
Practice address
926 Great Pond Dr Ste 1000
Altamonte Springs, FL 32714-7244
Phone
(407) 862-0444
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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 21317 FL Primary

Addresses

Primary practice location

926 Great Pond Dr Ste 1000
Altamonte Springs, FL 32714-7244

Mailing address

926 Great Pond Dr Ste 1000
Altamonte Springs, FL 32714-7244

Other names 1

  • Connie Liu Former name

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
I20150820011736 FL Order and Referring Only - DentistPractitioner - Dentist 0941515886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21317FLMDGeneral 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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1689057432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 GREAT POND DR STE 1000",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 GREAT POND DR STE 1000",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147244",
            "telephone_number": "407-862-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENG",
        "first_name": "CONNIE",
        "middle_name": "C. L.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "LIU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.