Active NPI
Mark Hermano, D.D.S.
- Pediatric Dentistry
- Kissimmee, FL
National Provider Identifier
1902342264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN 21745
- Practice address
- 1319 E Osceola Pkwy Ste C
Kissimmee, FL 34744-1606 - Phone
- (407) 733-0184
- NPI assigned
- Jan 11, 2017
- Last updated
- Aug 29, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN 21745 | FL | Primary |
Addresses
Primary practice location
1319 E Osceola Pkwy Ste C
Kissimmee, FL 34744-1606
Mailing address
6601 Bridgman St
Orlando, FL 32827-7941
Phone (407) 733-0184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 21745 | FL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1902342264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 BRIDGMAN ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328277941",
"telephone_number": "407-733-0184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 E OSCEOLA PKWY STE C",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347441606",
"telephone_number": "407-733-0184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMANO",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-11",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN 21745",
"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 Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.