Individual provider Active NPI

Gina Gisselle Asturrizaga, DDS

  • Dentist
  • Royal Palm Beach, FL
National Provider Identifier
1114555364
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D27344 Issued in FL
Practice address
11151 Southern Blvd Ste 110
Royal Palm Beach, FL 33411-4255
Phone
(561) 246-6371
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D27344 FL Primary

Addresses

Primary practice location

11151 Southern Blvd Ste 110
Royal Palm Beach, FL 33411-4255

Mailing address

7701 SW 157TH CT
Miami, FL 33193-2964
Phone (786) 610-8281

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Miami

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
I20221028002796 FL Order and Referring Only - DentistPractitioner - Dentist 1850768169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D27344FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Royal Palm, PA Dentist CurrentSince Aug 14, 2022 Accepting new patients

Locations

11151 Southern Blvd
Ste 110
Royal Palm Beach, FL 33411
Phone (561) 246-6371

Networks

  • Freedom Health HMO Network

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1114555364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 SW 157TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331932964",
            "telephone_number": "786-610-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11151 SOUTHERN BLVD STE 110",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334114255",
            "telephone_number": "561-246-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTURRIZAGA",
        "first_name": "GINA",
        "middle_name": "GISSELLE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "D27344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Miami",
            "affiliation": "N",
            "address_1": "7000 SW 62nd Ave Ste 401",
            "city": "South Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331434721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.