NPIMap

Organization Active NPI

Mary R. Isaacs, D.M.D., P.a.

  • General Practice Dentistry
  • Winter Springs, FL
National Provider Identifier
1811092893
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 13097 Issued in FL
Legal business name
MARY R. ISAACS, D.M.D., P.A.
Practice address
5965 Red Bug Lake Rd
Suite 233
Winter Springs, FL 32708-5080
Phone
(407) 696-5210
Fax
(407) 696-6488
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mary Rose Isaacs, D.M.D.NPI 1750486833
Title
President
Phone
(407) 696-5210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN 13097 FL Primary

Addresses

Primary practice location

5965 Red Bug Lake Rd
Suite 233
Winter Springs, FL 32708-5080

Mailing address

5965 Red Bug Lake Rd
Suite 233
Winter Springs, FL 32708-5080
Phone (407) 696-5210

Other identifiers 2

IdentifierTypeStateIssuer
69975OtherBLUE CROSS/BLUE SHIELD
642592OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

5965 Red Bug Lake Rd
Unit 233
Winter Springs, FL 32708
Phone (407) 696-5210

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811092893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 RED BUG LAKE RD",
            "address_2": "SUITE 233",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085080",
            "telephone_number": "407-696-5210",
            "fax_number": "407-696-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 RED BUG LAKE RD",
            "address_2": "SUITE 233",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085080",
            "telephone_number": "407-696-5210",
            "fax_number": "407-696-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY R. ISAACS, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ISAACS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-696-5210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 13097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "69975",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "642592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.