Individual provider Active NPI

Dwight E. Sanjuan, D.M.D.

  • Pediatric Dentistry
  • Tampa, FL
National Provider Identifier
1043310204
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN15486 Issued in FL
Practice address
6532 Gunn Hwy
Tampa, FL 33625-4022
Phone
(813) 969-0999
Fax
(813) 968-8875
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN15486 FL Primary

Addresses

Primary practice location

6532 Gunn Hwy
Tampa, FL 33625-4022

Mailing address

6532 Gunn Hwy
Tampa, FL 33625-4022
Phone (813) 969-0999

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
DN15486FLMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043310204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6532 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254022",
            "telephone_number": "813-969-0999",
            "fax_number": "813-968-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6532 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254022",
            "telephone_number": "813-969-0999",
            "fax_number": "813-968-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJUAN",
        "first_name": "DWIGHT",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN15486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.