Individual provider Active NPI

Kalina Uzunova-Dimova, D.D.S.

  • Dentist
  • Sunrise, FL
National Provider Identifier
1245540947
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21066 Issued in FL
Practice address
12801 W Sunrise Blvd
Sawgrass Mills Mall Dental, P. a., Ste 222
Sunrise, FL 33323-4020
Phone
(954) 846-7170
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21066 FL Primary

Addresses

Primary practice location

12801 W Sunrise Blvd
Sawgrass Mills Mall Dental, P. a., Ste 222
Sunrise, FL 33323-4020

Mailing address

12801 W Sunrise Blvd
Sawgrass Mills Mall Dental, P. a., Ste 222
Sunrise, FL 33323-4020
Phone (954) 846-7170

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

LicenseStateTypeSpecialty
DN21066FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
All Family Dental LLC Dentist CurrentSince May 14, 2023 Accepting new patients

Locations

10620 Griffin Rd
Ste 108
Davie, FL 33328
Phone (754) 300-9592

Networks

  • Freedom Health HMO Network

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": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1245540947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12801 W SUNRISE BLVD",
            "address_2": "SAWGRASS MILLS MALL DENTAL, P. A., STE 222",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333234020",
            "telephone_number": "954-846-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 W SUNRISE BLVD",
            "address_2": "SAWGRASS MILLS MALL DENTAL, P. A., STE 222",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333234020",
            "telephone_number": "954-846-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZUNOVA-DIMOVA",
        "first_name": "KALINA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.