MEDICARE: HORIZON DENTAL LLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1972462711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON DENTAL LLC

Provider Business Mailing Address
First Line	:	5807 ELLERBEE RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4202
Country	:	US
Telephone Number	:	971-205-0887
Fax Number	:

Provider Business Practice Location Address
First Line	:	5807 ELLERBEE RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4202
Country	:	US
Telephone Number	:	971-205-0887
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	SAM AYAD ISSA
Credential	:	DDS
Telephone Number	:	971-205-0887

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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