Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ideal Dental of Lake Nona PLLC

Organization Dentist · NPI 1821609454

Ideal Dental of Lake Nona PLLC is a Dentist 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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