Maria Mazzucco, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN15711 Issued in FL

Practice address

200 NW 7TH Ave
Fort Lauderdale, FL 33311-9026

Phone

(954) 759-6710

Fax

(954) 759-6767

NPI assigned

Feb 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Maria M Lugao Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1003941022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-759-6710",
            "fax_number": "954-759-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NW 7TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333119026",
            "telephone_number": "954-759-6710",
            "fax_number": "954-759-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZUCCO",
        "first_name": "MARIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075557500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83355",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "LUGAO",
            "middle_name": "M",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nathan Mayl, M.D.
• Naphtily Maynard-Saldenha
• Richard Anthony Mayora, LCSW
• Roxana Alexandra Maza
• Taylor Phillip Mazzei, DO
• Kelly Nji Mbenga, MD
• John Anthony McAuliffe, M.D.
• Sherene D McBean, ARNP
• Micheline McCabe, OT
• Doreen M McCallum

• Dentist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.