Individual provider Active NPI

Carl Edward Juliao, DMD

  • General Practice Dentistry
  • Winter Garden, FL
National Provider Identifier
1992930770
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 7872 Issued in FL
Practice address
13275 W Colonial Dr
Winter Garden, FL 34787-3984
Phone
(407) 905-8827
Fax
(407) 654-4079
NPI assigned
May 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 7872 FL Primary

Addresses

Primary practice location

13275 W Colonial Dr
Winter Garden, FL 34787-3984

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other practice location 1

849 Greenway Professional Ct
Orlando, FL 32824-9482
Phone (407) 905-8827

Other identifiers 1

IdentifierTypeStateIssuer
002981000MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 7872FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992930770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13275 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873984",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "849 Greenway Professional Ct",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328249482",
            "country_code": "US",
            "telephone_number": "407-905-8827",
            "fax_number": "321-221-1057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JULIAO",
        "first_name": "CARL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 7872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002981000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.