Individual provider Active NPI

Brian Oliver Coleman, M.D.

  • General Practice Dentistry
  • Winter Park, FL
National Provider Identifier
1720008121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11787 Issued in FL
Practice address
7200 Aloma Ave
Suite D
Winter Park, FL 32792-7133
Phone
(407) 671-1017
Fax
(407) 678-1339
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 11787 FL Primary

Addresses

Primary practice location

7200 Aloma Ave
Suite D
Winter Park, FL 32792-7133

Mailing address

7200 Aloma Ave
Suite D
Winter Park, FL 32792-7133
Phone (407) 671-1017

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329000008 FL Order and Referring Only - General PracticePractitioner - General Practice 2668779141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11787FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Dental Group, P.a. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720008121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 ALOMA AVE",
            "address_2": "SUITE D",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327927133",
            "telephone_number": "407-671-1017",
            "fax_number": "407-678-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 ALOMA AVE",
            "address_2": "SUITE D",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327927133",
            "telephone_number": "407-671-1017",
            "fax_number": "407-678-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BRIAN",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "11787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.