Southeastern Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

DN15714 Issued in FL

Legal business name

SOUTHEASTERN DENTAL GROUP

Doing business as

Family And Cosmetic Dentistry At Vista Lakes

Practice address

6415 South Chickasaw Trail
Orlando, FL 32829

Phone

(407) 382-2282

Fax

(407) 382-2858

NPI assigned

Aug 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Morra, DMDNPI 1720230329

Title

Managing Partner

Phone

(407) 382-2282

Specialties & licenses 2

Addresses

Other names 1

• Family And Cosmetic Dentistry At Vista Lakes Doing business as

Locations

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.

• Michael Jason Morra, D.M.D.

  • Dentist
  • Orlando, FL
  • NPI 1720230329
  NPD (past) Authorized official
• Marc R. Chapkis

  • Dentist
  • Orlando, FL
  • NPI 1063664662
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861403883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 SOUTH CHICKASAW TRAIL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32829",
            "telephone_number": "407-382-2282",
            "fax_number": "407-382-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 SOUTH CHICKASAW TRAIL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32829",
            "telephone_number": "407-382-2282",
            "fax_number": "407-382-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORRA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "407-382-2282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15714",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family And Cosmetic Dentistry At Vista Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Rehabilitation Center, Inc.
• Stacy Southall, RN
• Southchase Community Pharmacy (Patients First Pharmacy)
• Southeast Medical Imaging, Services
• Southeastern Clinical Services,Inc.
• Southern Surgical Services, LLC
• Liza Southerton, MS, RD, LDN
• Southpark Dental Group
• Southwest Anesthesia and Pain Management PA
• Southwest Infectious Disease Specialists LLC

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

• 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.