Individual provider Active NPI

Bernard M Florento, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1003977927
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D06432 Issued in AZ
Practice address
2330 N 75TH Ave Ste 112
Phoenix, AZ 85035-1200
Phone
(623) 849-0477
Fax
(623) 849-6111
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D06432 AZ Primary

Addresses

Primary practice location

2330 N 75TH Ave Ste 112
Phoenix, AZ 85035-1200

Mailing address

14560 W Medlock Dr
Litchfield Park, AZ 85340-2811
Phone (602) 828-0578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D06432AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1003977927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14560 W MEDLOCK DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853402811",
            "telephone_number": "602-828-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 N 75TH AVE STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850351200",
            "telephone_number": "623-849-0477",
            "fax_number": "623-849-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENTO",
        "first_name": "BERNARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D06432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.