NPIMap

Organization Active NPI

Kidzone Dentistry PA

  • Pediatric Dentistry
  • Gibsonton, FL
National Provider Identifier
1134531270
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN18289 Issued in FL
Legal business name
KIDZONE DENTISTRY PA
Practice address
13127 Kings Lake Dr Unit 101
Gibsonton, FL 33534-3958
Phone
(813) 677-3047
Fax
(813) 284-7959
NPI assigned
May 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Dr. Mounika Falemban, BDS, MDSNPI 1144472713
Title
Owner
Phone
(813) 408-4634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN18289 FL
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DN18289 FL Primary

Addresses

Primary practice location

13127 Kings Lake Dr Unit 101
Gibsonton, FL 33534-3958

Mailing address

6815 Scenic Dr
Apollo Beach, FL 33572-1543
Phone (813) 408-4634

Other identifiers 2

IdentifierTypeStateIssuer
007161100MedicaidFL
1144472713OtherFLNPI

National Provider Directory

National Provider Directory

Locations

13039 Summerfield Square Dr
Riverview, FL 33578

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1134531270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 SCENIC DR",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721543",
            "telephone_number": "813-408-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13127 KINGS LAKE DR UNIT 101",
            "city": "GIBSONTON",
            "state": "FL",
            "postal_code": "335343958",
            "telephone_number": "813-677-3047",
            "fax_number": "813-284-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZONE DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "FALEMBAN",
        "authorized_official_first_name": "MOUNIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-408-4634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BDS, MDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18289",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN18289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007161100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144472713",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.