Individual provider Active NPI

Alessandra Russell Da Cunha Coelho

  • Dentist
  • Plantation, FL
National Provider Identifier
1255176855
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29163 Issued in FL
Practice address
7420 NW 5TH St Ste 104
Plantation, FL 33317-1611
Phone
(954) 859-5538
Fax
(954) 859-5930
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29163 FL Primary

Addresses

Primary practice location

7420 NW 5TH St Ste 104
Plantation, FL 33317-1611

Mailing address

7420 NW 5TH St Ste 104
Plantation, FL 33317-1611
Phone (954) 859-5538

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
29163FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1255176855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 NW 5TH ST STE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333171611",
            "telephone_number": "954-859-5538",
            "fax_number": "954-859-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 NW 5TH ST STE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333171611",
            "telephone_number": "954-859-5538",
            "fax_number": "954-859-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL DA CUNHA COELHO",
        "first_name": "ALESSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "29163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.