Active NPI
Lourdes Milagros Cortes-Soto, DMD
- Pediatric Dentistry
- Tampa, FL
National Provider Identifier
1235114463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN 17501
- Practice address
- 4212 S Manhattan Ave
Tampa, FL 33611-1302 - Phone
- (813) 253-3679
- NPI assigned
- Dec 9, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 002632 | PR | |
| Pediatric Dentistry | 1223P0221X | DN 17501 | FL | Primary |
Addresses
Primary practice location
4212 S Manhattan Ave
Tampa, FL 33611-1302
Mailing address
4212 S Manhattan Ave
Tampa, FL 33611-1302
Phone (813) 253-3679
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 17501 | FL | MD | Pediatric Dentist |
| 002632 | PR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594598400000",
"number": "1235114463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4212 S MANHATTAN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336111302",
"telephone_number": "813-253-3679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 S MANHATTAN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336111302",
"telephone_number": "813-253-3679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORTES-SOTO",
"first_name": "LOURDES",
"middle_name": "MILAGROS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-09",
"last_updated": "2020-07-13",
"certification_date": "2020-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PR",
"license": "002632",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN 17501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.