Forest Lake Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

14761 Issued in FL

Legal business name

FOREST LAKE DENTAL GROUP

Practice address

628 North Bear Lake Road
Apopka, FL 32703

Phone

(407) 862-1231

Fax

(407) 862-1222

NPI assigned

Jul 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carlos Manuel Martin, DDSNPI 1528424983

Title

Owner

Phone

(407) 862-1231

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Carlos M Martin, D.D.S.

  • Dentist
  • Apopka, FL
  • NPI 1528424983
  NPD (past) Authorized official
• Karla Garcia, D.M.D

  • Dentist
  • Winter Springs, FL
  • NPI 1831870021
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1871783787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 NORTH BEAR LAKE ROAD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "407-862-1231",
            "fax_number": "407-862-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 NORTH BEAR LAKE ROAD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "407-862-1231",
            "fax_number": "407-862-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST LAKE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-862-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "14761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Institute of Dermatology LLC
• Florida Radiology Associates PA
• Florida Radiology Imaging at Lake Mary, LLC
• Henry Bascom Floyd IV, M.D.
• Ethan Rael Fluxman
• Naphtali Fortius
• Shinorff Fountain
• Cecilio Fowler
• Ashley Francis
• Christopher Bryan Francis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.