Shifat Hossain Mirza, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN24558 Issued in FL

Practice address

1200 Corporate Center Way Ste 103
Wellington, FL 33414-2108

Phone

(561) 798-0100

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Starr Family Dentistry, PA

  • Dental Clinic/Center
  • Wellington, FL
  • NPI 1558775155
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1235667304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE CENTER WAY STE 103",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334142108",
            "telephone_number": "561-798-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE CENTER WAY STE 103",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334142108",
            "telephone_number": "561-798-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "SHIFAT",
        "middle_name": "HOSSAIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Support Therapy
• Monica Miner, LMHC
• Olivia Minicucci, MS, RD
• Courtney Minors
• Ximena Minuche
• Wendy Ellen Mita, LCSW
• Crusita S Mitchell, RPH
• Erica Gasho Mitchell, FNP
• Leanne Mitchell, DIPL. L.AC, LMT, ES
• Sarah Elizabeth Mitchell, D.O.

• Dentist in Wellington, FL
• Providers in Wellington, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.