Individual provider Active NPI

Adam Minear Lazar, DMD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1861757460
Registry record updated Jan 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19831 Issued in FL
Practice address
304 E Colonial Dr
Orlando, FL 32801-1206
Phone
(407) 841-7321
NPI assigned
Jul 10, 2012
Last updated
Jan 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19831 FL Primary

Addresses

Primary practice location

304 E Colonial Dr
Orlando, FL 32801-1206

Mailing address

304 E Colonial Dr
Orlando, FL 32801-1206
Phone (407) 921-8662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150604000592 FL Order and Referring Only - DentistPractitioner - Dentist 4284955113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19831FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aml Dentistry Past Accepting new patients

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": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515196800000",
    "number": "1861757460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011206",
            "telephone_number": "407-921-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011206",
            "telephone_number": "407-841-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "ADAM",
        "middle_name": "MINEAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2018-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "19831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.