Active NPI
Rumaisa Altayib
- General Practice Dentistry
- Orlando, FL
National Provider Identifier
1912429309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN24683
- Practice address
- 4441 Hoffner Ave
Orlando, FL 32812-2331 - Phone
- (407) 218-4744
- NPI assigned
- Jul 7, 2017
- Last updated
- Aug 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12012804A | IN | |
| General Practice Dentistry | 1223G0001X | 2901022278 | MI | |
| General Practice Dentistry | 1223G0001X | DN24683 | FL | Primary |
Addresses
Primary practice location
4441 Hoffner Ave
Orlando, FL 32812-2331
Mailing address
1624 Caribou Hunt TRL
Orlando, FL 32824-5670
Phone (734) 239-2740
Other practice location 1
2429 Ellsworth Rd
Ypsilanti, MI 48197
Phone (734) 434-0043
Other practice location 2
4675 E SR 44 Ste 104
Wildwood, FL 34785-7461
Phone (352) 418-3041
Other practice location 3
2429 Ellsworth Rd
Ypsilanti, MI 48197
Phone (734) 434-0043
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 |
|---|---|---|---|
| DN24683 | FL | MD | General Practice Dentistry |
| 12012804A | IN | MD | General Practice Dentistry |
| 2901022278 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Dreams PLLC | General Practice | Past | Accepting new patients |
| Sage Dental of Conway PLLC | Past | Accepting new patients | |
| Wildwood Dentists, PA | General Practice | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dentist
- Belle Isle, FL
- NPI 1295110302
-
- General Practice Dentistry
- Ypsilanti, MI
- NPI 1124440391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1912429309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 CARIBOU HUNT TRL",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328245670",
"telephone_number": "734-239-2740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4441 HOFFNER AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328122331",
"telephone_number": "407-218-4744"
}
],
"practiceLocations": [
{
"address_1": "2429 Ellsworth Rd",
"address_purpose": "LOCATION",
"city": "Ypsilanti",
"state": "MI",
"postal_code": "48197",
"country_code": "US",
"telephone_number": "734-434-0043",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4675 E SR 44 Ste 104",
"address_purpose": "LOCATION",
"city": "Wildwood",
"state": "FL",
"postal_code": "347857461",
"country_code": "US",
"telephone_number": "352-418-3041",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2429 Ellsworth Rd",
"address_purpose": "LOCATION",
"city": "Ypsilanti",
"state": "MI",
"postal_code": "48197",
"country_code": "US",
"telephone_number": "734-434-0043",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALTAYIB",
"first_name": "RUMAISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-07",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12012804A",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901022278",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN24683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
- Madison Altamirano, RBT
- Altamonte Springs Diagnostic Imaging Inc (Mid Florida Imaging)
- Altamonte Springs Diagnostic Imaging Inc (Mid Florida Imaging)
- Altamonte Springs Diagnostic Imaging Inc (Mid Florida Imaging)
- Mahmoud Altawil, MD
- Herna Cyprien Altenor, D.C
- Altermease S Kimble (Quality Lifestyle Services)
- Alternative Behavior Consultants Inc.
- Alternative Directions Counseling & Consulting, LLC
- Alternative Directions, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.