Amber Lynn Medellin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN24862 Issued in FL

Practice address

8801 Commodity Cir
Orlando, FL 32819-9053

Phone

(407) 248-0100

NPI assigned

May 26, 2020

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Southpark Dental Group

  • Dentist
  • Orlando, FL
  • NPI 1093815029

  General Practice

  NPD (past)

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1720601628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 COMMODITY CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328199053",
            "telephone_number": "407-248-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 COMMODITY CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328199053",
            "telephone_number": "407-248-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDELLIN",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Max B Medary, M.D.
• Medcare Transport Corp (Medcare Transport)
• Medcare Xpress Walk in Clinic of Semoran
• Medcare Xpress Walk-in Clinic of Avalon, LLC
• Priscilla Nunes Medeiros, APRN
• Emily Medelus
• Naile Mederos Salgado
• Orlando Noel Mederos Trujillo, MD
• Medfund LLC (Horizon Orlando One LLC)
• Babak Medhat, RRT

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.