Healthcare Provider Details

I. General information

NPI: 1013120310
Provider Name (Legal Business Name): ANGELA STALLARD D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA WILLOX D.M.D.

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 MAGUIRE RD STE 100
OCOEE FL
34761-4750
US

IV. Provider business mailing address

2930 MAGUIRE RD STE 100
OCOEE FL
34761-4750
US

V. Phone/Fax

Practice location:
  • Phone: 407-984-4890
  • Fax: 407-984-4891
Mailing address:
  • Phone: 407-984-4890
  • Fax: 407-984-4891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN22269
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: