Individual provider Active NPI

Idelbis Lago-Sanchez, DMD

  • Dentist
  • Palm Springs, FL
National Provider Identifier
1003248824
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 20246 Issued in FL
Practice address
3729 Lake Worth Rd
Palm Springs, FL 33461-4033
Phone
(561) 201-8078
Fax
(561) 584-7726
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 20246 FL Primary

Addresses

Primary practice location

3729 Lake Worth Rd
Palm Springs, FL 33461-4033

Mailing address

7437 Pine Tree LN
Lake Clarke Shores
West Palm Beach, FL 33406-6820
Phone (561) 201-1713

Other identifiers 1

IdentifierTypeStateIssuer
009877200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331002509 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395042691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 20246FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Spring Dental LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • FL HMO C-SNP
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • FL HMO D-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003248824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7437 PINE TREE LN",
            "address_2": "LAKE CLARKE SHORES",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066820",
            "telephone_number": "561-201-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3729 LAKE WORTH RD",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334614033",
            "telephone_number": "561-201-8078",
            "fax_number": "561-584-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGO-SANCHEZ",
        "first_name": "IDELBIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009877200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

Verify at the official NPI Registry.