Individual provider Active NPI

Ela Maria Torres-Moore, DMD

  • General Practice Dentistry
  • Lakeland, FL
National Provider Identifier
1255472387
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14673 Issued in FL
Practice address
4744 S Florida Ave
Lakeland, FL 33813-2181
Phone
(863) 644-1226
NPI assigned
Feb 9, 2007
Last updated
Mar 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DN14673 FL
General Practice Dentistry 1223G0001X DN14673 FL Primary

Addresses

Primary practice location

4744 S Florida Ave
Lakeland, FL 33813-2181

Mailing address

308 E. Park St
Auburndale, FL 33823
Phone (863) 967-7548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322000750 FL Order and Referring Only - DentistPractitioner - Dentist 0547500878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thurston & Acosta Dental Associates,PL General Practice Past Accepting new patients
Thurston Comprehensive Dental Center General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1255472387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E. PARK ST",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "33823",
            "telephone_number": "863-967-7548",
            "fax_number": "863-967-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132181",
            "telephone_number": "863-644-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES-MOORE",
        "first_name": "ELA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN14673",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.