NPIMap

Individual provider Active NPI

Stefani Joy Allison, D.M.D.

  • General Practice Dentistry
  • Winter Haven, FL
National Provider Identifier
1205191939
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 19768 Issued in FL
Practice address
200 Avenue K SE Ste 1
Winter Haven, FL 33880-4003
Phone
(863) 299-2192
Fax
(863) 293-4219
NPI assigned
Jul 9, 2012
Last updated
Jul 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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 19768 FL Primary

Addresses

Primary practice location

200 Avenue K SE Ste 1
Winter Haven, FL 33880-4003

Mailing address

200 Avenue K SE Ste 1
Winter Haven, FL 33880-4003
Phone (863) 299-2192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224001227 FL Order and Referring Only - DentistPractitioner - Dentist 2567767833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 19768FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. General Practice Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients
Central Florida Health Care Inc General Practice Past Accepting new patients
Nicole R. Klein DMD PA PastSince Apr 30, 2023 Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. General Practice Past Accepting new patients
Central Florida Health Care, Inc General Practice Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1205191939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVENUE K SE STE 1",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804003",
            "telephone_number": "863-299-2192",
            "fax_number": "863-293-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE K SE STE 1",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804003",
            "telephone_number": "863-299-2192",
            "fax_number": "863-293-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "STEFANI",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 19768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.