DR. JONATHAN M NITISUSANTA DDS
NPI 1134283252
Dentist in Ocoee, FL

Q: What is Jonathan Nitisusanta's NPI number?

The NPI number for Jonathan Nitisusanta is 1134283252. It was assigned to this individual provider in the NPPES registry on December 21, 2006.

Q: What is Jonathan Nitisusanta's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since December 21, 2006

2704 REW CIR, SUITE103, OCOEE, FL 34761(407) 877-9003 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Jonathan M Nitisusanta Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN M NITISUSANTA DDS (NPI 1134283252) is an individual dentist in Ocoee, Florida, licensed in Florida (DN13138) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1134283252

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JONATHAN M NITISUSANTACredential: DDS

Location Address2704 REW CIR, SUITE103Ocoee, FL 34761-2994

Mailing Address10048 Brandon CirOrlando, FL 32836-3714 · (407) 877-9003

Phone(407) 877-9003

Sole ProprietorYes

Enumeration DateDecember 21, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1134283252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in FL · DN13138

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2704 REW CIR, Ocoee, FL 34761

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

1 VILLAGE 1 CHILD

Community/Behavioral Health

2704 REW CIR
OCOEE, FL 34761

Orange County (321) 356-9352

DR. YVONNE BERNADETTE SEBALLO LMHC

Counselor (Mental Health)

2704 REW CIR, SUITE 105F
OCOEE, FL 34761

Orange County (407) 902-5576

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Nitisusanta's NPI number?

The NPI number for Jonathan Nitisusanta is 1134283252. It was assigned to this individual provider in the NPPES registry on December 21, 2006.

Where is Jonathan Nitisusanta located?

Jonathan Nitisusanta practices at 2704 Rew Cir Suite103, Ocoee, FL 34761. The listed phone number is (407) 877-9003.

What is Jonathan Nitisusanta's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Jonathan Nitisusanta accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 7 other insurers list Jonathan Nitisusanta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jonathan Nitisusanta was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.