Individual provider Active NPI

Kelvin Lantigua, DMD

  • General Practice Dentistry
  • Hollywood, FL
National Provider Identifier
1215944368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16003 Issued in FL
Practice address
7076 Taft St
Hollywood, FL 33024-3860
Phone
(954) 964-1494
Fax
(954) 964-5195
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN16003 FL Primary

Addresses

Primary practice location

7076 Taft St
Hollywood, FL 33024-3860

Mailing address

7076 Taft St
Hollywood, FL 33024-3860
Phone (954) 964-1494

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
I20240208001332 FL Practitioner - Dentist 5092014589 Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kelvin Lantigua, DMD, PA General Practice CurrentSince Jan 16, 2024 Accepting new patients

Locations

7076 Taft St
Hollywood, FL 33024
Phone (954) 964-1494

Organizations & group practices 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215944368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7076 TAFT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243860",
            "telephone_number": "954-964-1494",
            "fax_number": "954-964-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7076 TAFT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243860",
            "telephone_number": "954-964-1494",
            "fax_number": "954-964-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTIGUA",
        "first_name": "KELVIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.