Lucelia Santos Avila, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28677 Issued in FL

Practice address

2505 S Federal Hwy
Fort Pierce, FL 34982-5922

Phone

(772) 464-4646

NPI assigned

May 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: lucelia.santos.avila.1@18107.direct.athenahealth.com

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.

• Dentaland, Ft Pierce

  • Dentist
  • Fort Pierce, FL
  • NPI 1023250255
  NPD (past)

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1164113106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 SW NORTHLAND DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349871937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 S FEDERAL HWY",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825922",
            "telephone_number": "772-464-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104572545",
            "country_code": "US",
            "telephone_number": "718-960-6619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS AVILA",
        "first_name": "LUCELIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjiv Walia MD PA
• Ermionne Sanon
• Marnie L Sanon
• Catherine E. Lozada Santee, LMT
• Sonja T Santiago, LMT
• Rosangela Santos-Kolp, LPN
• Dora Estela Sarli, P.T.
• Fazeel Sarmad, MD
• Simon Sarmiento
• Sassoon Psychiatric Services, P.C.

• General Practice Dentistry in Fort Pierce, FL
• Providers in Fort Pierce, 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 Sep 3, 2024; 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.