Provider Demographics
NPI:1992543185
Name:NEGRIN, AMANDA SEASON (DMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:SEASON
Last Name:NEGRIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8839 BAY HARBOUR BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5017
Mailing Address - Country:US
Mailing Address - Phone:407-970-0076
Mailing Address - Fax:
Practice Address - Street 1:9625 LAKE NONA VILLAGE PL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7319
Practice Address - Country:US
Practice Address - Phone:407-986-8483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29383122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist