MEDICARE: WINTER SPRINGS FAMILY DENTISTRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1205626710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINTER SPRINGS FAMILY DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	5220 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4912
Country	:	US
Telephone Number	:	407-706-3434
Fax Number	:

Provider Business Practice Location Address
First Line	:	5220 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4912
Country	:	US
Telephone Number	:	407-706-3434
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NIMISH MANIAR
Credential	:	DMD
Telephone Number	:	954-701-0871

Provider Enumeration Date	:	05/08/2025
Last Update Date	:	05/08/2025

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