Individual provider Active NPI

Yarelis Cartagena, DMD

  • General Practice Dentistry
  • Lakeland, FL
National Provider Identifier
1205077013
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 18885 Issued in FL
Practice address
3436 S Florida Ave
Suite 100
Lakeland, FL 33803-4765
Phone
(863) 607-4700
Fax
(863) 607-4434
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 18885 FL Primary

Addresses

Primary practice location

3436 S Florida Ave
Suite 100
Lakeland, FL 33803-4765

Mailing address

3685 Fallscrest Cir
Clermont, FL 34711-6672
Phone (787) 344-0087

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
I20160728000883 FL Order and Referring Only - DentistPractitioner - Dentist 8224321294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 18885FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
SNJ Dental Studio, LLC General Practice PastSince Mar 24, 2024 Accepting new patients
Herman Singh DMD PLLC General Practice PastSince Dec 22, 2024 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1205077013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3685 FALLSCREST CIR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116672",
            "telephone_number": "787-344-0087",
            "fax_number": "863-607-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 S FLORIDA AVE",
            "address_2": "SUITE 100",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034765",
            "telephone_number": "863-607-4700",
            "fax_number": "863-607-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTAGENA",
        "first_name": "YARELIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.