MOUNT DORA MODERN DENTISTRY, PA (NPI# 1659815306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659815306 |
| Entity Type | Organization |
| Organization Name | MOUNT DORA MODERN DENTISTRY, PA |
| Other Organization Name | MOUNT DORA MODERN DENTISTRY |
| Practice Address |
17365 Us Hwy 441 Eustis FL 32757 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 3522703015 |
| Mailing Telephone | 7148458500 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2017-01-05 |
| Authorized Official Name | KATIE MCCANN (OWNER) |
| Authorized Official Telephone | 3522703015 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Mount Dora Modern Dentistry | Doing Business As Name - Organization |
| Street Address |
17365 US HWY 441 |
| City | EUSTIS |
| State | FL |
| Zip Code | 32757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324824 | Cypress Grove Counseling Center LLC | Counselor | 6551 N Orange Blossom Trail Suite 209 #1005, Mount Dora, FL 32757 | 2020-07-28 |
| 1790327286 | Alisha Dawn Bateman | Nurse Practitioner | 7678 Lake Ola Dr., Mount Dora, FL 32757 | 2019-10-16 |
| 1306496153 | Carehere LLC | Family Medicine | Carehere Clinic- City of Mount Dora, Fl, 2110 North Donnelly Street, Mt Dora, FL 32757 | 2019-09-13 |
| 1871008680 | Sonya Quiroz | Behavior Technician | 21038 Niles Ave, Mount Dora, FL 32757 | 2017-12-04 |
| 1043737661 | Erin N Booth | Behavior Technician | 411 N. Donnelly St., Suite 307, Mount Dora, FL 32757 | 2017-08-24 |
| 1053850073 | Sunshine Recovery Network, Inc | Community/Behavioral Health | 632 E 5th Ave, Mount Dora, FL 32757 | 2017-02-23 |
| 1336684661 | Catherine Lim Panlilio | Physical Therapist | 300 Brookfield Avenue, Mount Dora, FL 32757 | 2016-12-22 |
| 1447603303 | Lake County Adult Activity Center Inc | Respite Care | 1934 N Donnelly St, Suite B, Mount Dora, FL 32757 | 2016-07-15 |
| 1871955724 | Sagir Patel | Dentist | 17365 Us Highway 441, Mount Dora, FL 32757 | 2016-03-22 |
| 1992198204 | Wendy Donald | Counselor | 6215 Holly St, Mount Dora, FL 32757 | 2015-03-11 |
| Find all providers in zip 32757 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801919345 | Vernon Dale Meeks | Dentist | 980 Mount Homer Rd, Eustis, FL 32726-6258 | 2007-04-09 |
| 1902983018 | Charles Estes Broadway | Dentist | 1141 S Eustis St, Eustis, FL 32726-5558 | 2006-11-01 |
| 1790304590 | Summer B Young | Dentist | 15 W Atwater Ave, Eustis, FL 32726-5401 | 2020-04-11 |
| 1538684410 | Monique P. Alves | Dentist | 15455 Us Highway 441, Eustis, FL 32726-8321 | 2017-08-11 |
| 1972039493 | Linda Thanh Nguyen | Dentist | 15455 Us Highway 441, Eustis, FL 32726 | 2017-05-03 |
| 1326491853 | Anthony A. Azadi | Dentist | 15455 Us Highway 441, Eustis, FL 32726-8321 | 2016-07-20 |
| 1588863427 | Adam Justin Barr | Dentist | 980 Mount Homer Rd, Eustis, FL 32726-6258 | 2007-07-11 |
| 1649499948 | Matthew Joseph Jackson | Dentist | 1141 S Eustis St, Eustis, FL 32726-5558 | 2007-04-25 |
| 1740367879 | Charles E Broadway, Dmd, Pa | Dentist | 1141 S Eustis St, Eustis, FL 32726-5558 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326843 | Stellar Smiles Inc. | Dentist | 1501 Corporate Dr Apt 311, Boynton Beach, FL 33426-6600 | 2020-11-07 |
| 1962003269 | Magic Touch Dentistry, P.a. | Dentist | 2 Oakwood Blvd Ste 150a, Hollywood, FL 33020-1960 | 2020-11-03 |
| 1982203584 | Crystel Ananos Riggs Dmd Pa | Dentist | 900 Se Ocean Blvd Ste 248, Stuart, FL 34994-3501 | 2020-10-23 |
| 1053910315 | Dental Buddies of Vero Beach | Dentist | 3755 7th Ter Ste 303, Vero Beach, FL 32960-6547 | 2020-10-19 |
| 1295332013 | Dentists of Nona, Pa | Dentist | 14019 Narcoossee Rd Ste 135, Orlando, FL 32832-7162 | 2020-10-05 |
| 1073110177 | Coral Springs Dental Group, LLC | Dentist | 2029 N University Dr, Coral Springs, FL 33071-6132 | 2020-10-02 |
| 1316554686 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 15800 Orange Blvd, Loxahatchee, FL 33470-3442 | 2020-09-30 |
| 1861009136 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 5068 W State Road 46, Sanford, FL 32771-9246 | 2020-09-30 |
| 1003423922 | Aurora Dental Group, P.a | Dentist | 6176 Sw 8 Street, Miami, FL 33144 | 2020-09-24 |
| 1063029122 | Steven Gross | Dentist | 2021 Ne 210th St, Miami, FL 33179-1629 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.