Individual provider Active NPI

Luisa Fernanda Betancur

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ocala, FL
National Provider Identifier
1225457658
Registry record updated Jul 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
20664 Issued in FL
Practice address
1800 SE 17TH St
500
Ocala, FL 34471-4191
Phone
(352) 368-9099
NPI assigned
Apr 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 20664 FL Primary

Addresses

Primary practice location

1800 SE 17TH St
500
Ocala, FL 34471-4191

Mailing address

6365 SW 134TH Loop
Ocala, FL 34473-8195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20664FLMDOrthodontics and Dentofacial Orthopedic Dentist
9490KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ford Orthodontics, P.a. Orthodontics and Dentofacial Orthopedics Past Accepting new patients

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468108800000",
    "number": "1225457658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6365 SW 134TH LOOP",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344738195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE 17TH ST",
            "address_2": "500",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714191",
            "telephone_number": "352-368-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCUR",
        "first_name": "LUISA",
        "middle_name": "FERNANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2016-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "20664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2016; 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.