Organization Active NPI

House of Cosmetic Dentistry

Doing business as Fortune Dental

  • Dentist
  • Kissimmee, FL
National Provider Identifier
1740568187
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN16387 Issued in FL
Legal business name
HOUSE OF COSMETIC DENTISTRY
Doing business as
Fortune Dental
Practice address
2324 Fortune Rd
Kissimmee, FL 34744-3993
Phone
(407) 348-2002
Fax
(407) 348-2009
NPI assigned
Aug 3, 2011
Last updated
Sep 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Authorized official

Name
Ms. Lina Segura
Title
Office Manager
Phone
(407) 348-2002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN16387 FL Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN16586 FL

Addresses

Primary practice location

2324 Fortune Rd
Kissimmee, FL 34744-3993

Mailing address

2324 Fortune Rd
Kissimmee, FL 34744-3993
Phone (407) 348-2002

Other names 1

  • Fortune Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2324 Fortune Rd
Kissimmee, FL 34744
Phone (407) 348-2002

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1740568187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443993",
            "telephone_number": "407-348-2002",
            "fax_number": "407-348-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443993",
            "telephone_number": "407-348-2002",
            "fax_number": "407-348-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "SEGURA",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-348-2002",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16387",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fortune Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.