NPIMap

Organization Active NPI

Luminary Dental

  • Dentist
  • Cocoa, FL
National Provider Identifier
1972433084
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LUMINARY DENTAL
Practice address
1178 Fay Blvd
Cocoa, FL 32927-8739
Phone
(321) 343-3979
Fax
(321) 220-9697
NPI assigned
May 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
Owais Khan, DDSNPI 1821793001
Title
Dentist/Owner
Phone
(321) 343-3979

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1178 Fay Blvd
Cocoa, FL 32927-8739

Mailing address

1178 Fay Blvd
Cocoa, FL 32927-8739
Phone (321) 343-3979

National Provider Directory

National Provider Directory

Locations

1178 Fay Blvd
Cocoa, FL 32927
Phone (321) 343-3979

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1972433084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 FAY BLVD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329278739",
            "telephone_number": "321-343-3979",
            "fax_number": "321-220-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 FAY BLVD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329278739",
            "telephone_number": "321-343-3979",
            "fax_number": "321-220-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINARY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "OWAIS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "321-343-3979",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.