MEDICARE: LUMIERE COSMETIC AND IMPLANT DENTISTRY

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	:	1699341156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMIERE COSMETIC AND IMPLANT DENTISTRY

Provider Business Mailing Address
First Line	:	1588 SLASH PINE PL
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-8467
Country	:	US
Telephone Number	:	407-865-0987
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N ORLANDO AVE STE 115
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-4704
Country	:	US
Telephone Number	:	407-680-0790
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MEHRSHAD YOUSEFI
Credential	:	DMD
Telephone Number	:	407-865-0987

Provider Enumeration Date	:	06/03/2021
Last Update Date	:	04/15/2024

Similar Medicare Providers

1346701018 — SAJID KHAN APRN
Practice Location Address:

2201 LUCIEN WAY STE 200
MAITLAND, FL
32751-7003

Practice Phone: 877-868-4827
Practice Fax:

1083546527 — DIEGO ALONSO CHAVEZ
Practice Location Address:

601 S LAKE DESTINY RD STE 350
MAITLAND, FL
32751-7222

Practice Phone: 407-647-6555
Practice Fax:

1841380433 — GAVIN NICHOLAS VAN STADEN MD
Practice Location Address:

402 LAKE HOWELL RD
MAITLAND, FL
32751-5907

Practice Phone: 407-628-4312
Practice Fax:

1649881434 — DR JOSE A RIVERA LLC
Practice Location Address:

850 CONCOURSE PKWY S STE 200
MAITLAND, FL
32751-6145

Practice Phone: 251-901-3011
Practice Fax:

1073450342 — VITTORIA RIVERA LMHC
Practice Location Address:

603 ORANGE TREE CT
MAITLAND, FL
32751-6367

Practice Phone: 407-235-2605
Practice Fax:

1043033798 — AISHAH FERNANDEZ
Practice Location Address:

601 S LAKE DESTINY RD STE 350
MAITLAND, FL
32751-7222

Practice Phone: 407-616-0493
Practice Fax:

Directions to “LUMIERE COSMETIC AND IMPLANT DENTISTRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.