NPIMap

Organization Active NPI

Av Dental, PA

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1912077199
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 12611 Issued in FL
Legal business name
AV DENTAL, PA
Practice address
2506 S Semoran Blvd
Orlando, FL 32822-2710
Phone
(407) 273-4100
Fax
(407) 273-4201
NPI assigned
Nov 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Myrna Rodriguez, DMDNPI 1235229733
Title
President
Phone
(407) 273-4100

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
General Practice Dentistry 1223G0001X DN 12611 FL Primary

Addresses

Primary practice location

2506 S Semoran Blvd
Orlando, FL 32822-2710

Mailing address

2506 S Semoran Blvd
Orlando, FL 32822-2710
Phone (407) 273-4100

National Provider Directory

National Provider Directory

Locations

2506 S Semoran Blvd
Orlando, FL 32822
Phone (407) 273-4100

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912077199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 S SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328222710",
            "telephone_number": "407-273-4100",
            "fax_number": "407-273-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 S SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328222710",
            "telephone_number": "407-273-4100",
            "fax_number": "407-273-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-273-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 12611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • 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.