RICARDO CARLO CARRILLO DDS NPI 1174979991

NPI Information

NPI: 1174979991
Provider Name: RICARDO CARLO CARRILLO, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
1993 DANIELS RD STE 120
WINTER GARDEN, FL
ZIP 34787
Phone: (407) 395-9335
Get Directions

Ricardo Carlo Carrillo, DDS is a general practice dentist in Winter Garden, FL. The provider is 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. Ricardo Carlo Carrillo, DDS NPI is 1174979991. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1993 DANIELS RD STE 120
WINTER GARDEN, FL
ZIP 34787-598
Phone: (407) 395-9335

The NPI 1174979991 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/11/2016 and was last updated on 1/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	23339	FLORIDA	Yes
2	390200000X	Student in an Organized Health Care Education/Training Program		1507	FLORIDA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1174979991	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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