Kasem Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KASEM DENTAL LLC

Doing business as

Hancock Village Dental

Practice address

2560 E Hwy 50 Ste 103
Clermont, FL 34711-8411

Phone

(352) 989-5815

NPI assigned

Jul 19, 2024

Organization subpart

No

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

Authorized official

Name

Nusrat Kasem

Title

Manager

Phone

(850) 443-4879

Specialties & licenses 1

Addresses

Other names 1

• Hancock Village Dental Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Shovon Sayfaldin Kasem, D.M.D.

  • Dentist
  • Clermont, FL
  • NPI 1497181739
  Medicare reassignment NPD
• Dolly Acosta

  • Dental Hygienist
  • Clermont, FL
  • NPI 1619421898
  NPD (past)
• Edwin Acosta, DDS

  • General Practice Dentistry
  • Clermont, FL
  • NPI 1578729711
  NPD (past)

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1962240127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 SADIE RIDGE RD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347150027",
            "telephone_number": "850-443-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 E HWY 50 STE 103",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118411",
            "telephone_number": "352-989-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KASEM DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "KASEM",
        "authorized_official_first_name": "NUSRAT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-443-4879"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hancock Village Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Louis John Kantounis, MD
• Andrew D Karen, M.D.
• Jill Lynn Karnolt, RPH
• Elizabeth Karpov, RBT
• Angelica Kartsonis
• Shovon Sayfaldin Kasem, D.M.D.
• Santosh Reddy Katta, PHARMD
• Rupinder Preet Kaur, M.D.
• Punita Kaveti, MD
• Stephanie Nicole Kay

• General Practice Dentistry in Clermont, FL
• Providers in Clermont, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.