Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Ideal Dental of Lake Nona PLLC

Organization Dentist · NPI 1821609454

Ideal Dental of Lake Nona PLLC provides Dentist services in Orlando, Florida. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12851 Narcoossee Rd Ste 102
Orlando, FL 32832-7156
Phone: (407) 749-1560
Fax: (407) 550-6210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1821609454
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Coussa — Owner · (972) 331-8079
NPI enumeratedAugust 17, 2020
Last updated in NPPESOctober 2, 2023
Certification dateOctober 2, 2023
Mailing addressPo Box 840925, Dallas, TX 75284-0925

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