Healthcare Provider Details

I. General information

NPI: 1508931270
Provider Name (Legal Business Name): VENIAMIN V. KALMANOVICH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11202 DOWDEN RD UNIT 1
ORLANDO FL
32832-5201
US

IV. Provider business mailing address

4507 CRESTHAVEN DR
COLLEYVILLE TX
76034-4576
US

V. Phone/Fax

Practice location:
  • Phone: 508-904-8499
  • Fax:
Mailing address:
  • Phone: 508-904-8499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19937
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN30128
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number34941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: