Julio Lara, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS041693 Issued in PA

Practice address

302 W Fletcher Ave
Tampa, FL 33612-3415

Phone

(813) 397-5305

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1114454915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123415",
            "telephone_number": "813-397-5305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171041123",
            "country_code": "US",
            "telephone_number": "717-232-9971",
            "fax_number": "717-920-3039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "JULIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103549337-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Lara Rojas
• Lara Wittine, PLLC
• Angel L Lara
• Elena C Lara, SW
• Ione Vildria Lara, MD
• Arnel K Larcia, MD
• Travis L Larimore, PAC
• Elizabeth Ann Larino, FNP
• Larjar
• Viron Lark

• General Practice Dentistry in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.