Active NPI
Fabiola Maria Douglas, DDS
- Endodontics
- Kissimmee, FL
National Provider Identifier
1831753052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN25777
- Practice address
- 909 N Central Ave
Kissimmee, FL 34741-5029 - Phone
- (407) 933-0885
- Fax
- (407) 933-0520
- NPI assigned
- Apr 23, 2019
- Last updated
- Jan 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN25777 | FL | Primary |
Addresses
Primary practice location
909 N Central Ave
Kissimmee, FL 34741-5029
Mailing address
909 N Central Ave
Kissimmee, FL 34741-5029
Phone (407) 933-0885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 2, 2021 through Nov 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN25777 | FL | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fabiola Douglas DDS, LLC | Endodontics | Current | Accepting new patients |
Locations
909 N Central Ave
Kissimmee, FL 34741
Phone (407) 649-1878
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": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1831753052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 N CENTRAL AVE",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415029",
"telephone_number": "407-933-0885",
"fax_number": "407-933-0520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 N CENTRAL AVE",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415029",
"telephone_number": "407-933-0885",
"fax_number": "407-933-0520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "FABIOLA",
"middle_name": "MARIA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-23",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN25777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.