Your Kissimmee Dentist PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

YOUR KISSIMMEE DENTIST PA

Practice address

1135 W Columbia Ave
Kissimmee, FL 34741-3202

Phone

(407) 933-4343

Fax

(407) 944-1434

NPI assigned

Aug 27, 2024

Organization subpart

No

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

Authorized official

Name

Carlos Medina, DMDNPI 1396944351

Title

Dentist

Phone

(386) 717-5458

Specialties & licenses 1

Addresses

Other names 1

• Columbia Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlos Medina, DMD

  • General Practice Dentistry
  • Orlando, FL
  • NPI 1396944351
  NPD Authorized official

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1750115424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13151 PALOMA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378723",
            "telephone_number": "808-407-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W COLUMBIA AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413202",
            "telephone_number": "407-933-4343",
            "fax_number": "407-944-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR KISSIMMEE DENTIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "386-717-5458",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Khadejra Young
• Mariana Young, MSN, APRN, FNP-C
• Nicole Jean Young
• Your Health Center, LLC
• Your Health Pediatrics, Inc
• Your Way Transportation Services LLC
• Mohamed Yousif
• Fatema Youssef
• Yp4 Transportation LLC
• Emily Yu

• Dentist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.