NPIMap

Organization Active NPI

Winter Garden Smiles, PL

  • Dental Clinic/Center
  • Winter Garden, FL
National Provider Identifier
1861762411
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN17413 Issued in FL
Legal business name
WINTER GARDEN SMILES, PL
Practice address
1291 Winter Garden Vineland Rd
Suite 140
Winter Garden, FL 34787-6705
Phone
(407) 614-5955
Fax
(407) 614-5001
NPI assigned
Jan 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Dr. Lissette R Bernal, DDSNPI 1437136082
Title
Pediatric Dentist
Phone
(407) 694-8144

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
Dental Clinic/Center 261QD0000X DN17413 FL Primary

Addresses

Primary practice location

1291 Winter Garden Vineland Rd
Suite 140
Winter Garden, FL 34787-6705

Mailing address

1291 Winter Garden Vineland Rd
Suite 140
Winter Garden, FL 34787-6705
Phone (407) 614-5955

National Provider Directory

National Provider Directory

Locations

1291 Winter Garden Vineland Rd
Ste 140
Winter Garden, FL 34787
Phone (407) 614-5955

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": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1861762411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 WINTER GARDEN VINELAND RD",
            "address_2": "SUITE 140",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876705",
            "telephone_number": "407-614-5955",
            "fax_number": "407-614-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 WINTER GARDEN VINELAND RD",
            "address_2": "SUITE 140",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876705",
            "telephone_number": "407-614-5955",
            "fax_number": "407-614-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTER GARDEN SMILES, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "BERNAL",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "407-694-8144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN17413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.