Individual provider Active NPI

Sabina Vlaeva, DMD

  • Dentist
  • South Pasadena, FL
National Provider Identifier
1205312980
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23601 Issued in FL
Practice address
6882 Gulfport Blvd S
South Pasadena, FL 33707-2108
Phone
(727) 384-9655
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23601 FL Primary

Addresses

Primary practice location

6882 Gulfport Blvd S
South Pasadena, FL 33707-2108

Mailing address

6882 Gulfport Blvd S
South Pasadena, FL 33707-2108
Phone (727) 384-9655

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
I20210818003337 FL Order and Referring Only - DentistPractitioner - Dentist 5799180410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23601FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients

Locations

6882 Gulfport Blvd S
South Pasadena, FL 33707
Phone (727) 384-9655

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1205312980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6882 GULFPORT BLVD S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337072108",
            "telephone_number": "727-384-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6882 GULFPORT BLVD S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337072108",
            "telephone_number": "727-384-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLAEVA",
        "first_name": "SABINA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, FL

Sources for this page

Verify at the official NPI Registry.