Individual provider Active NPI

Mary Labance, DMD

  • Dentist
  • Clearwater, FL
National Provider Identifier
1255826715
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23600 Issued in FL
Practice address
23680 US 19 N
Clearwater, FL 33765-1571
Phone
(727) 799-1010
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23600 FL Primary

Addresses

Primary practice location

23680 US 19 N
Clearwater, FL 33765-1571

Mailing address

6435 92ND PL N Apt 906
Pinellas Park, FL 33782-4631

Other practice location 1

916 Curlew Rd
Dunedin, FL 34698-1901
Phone (727) 736-1777

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
I20180906000404 FL Order and Referring Only - DentistPractitioner - Dentist 6305196726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist Past Accepting new patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1255826715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 92ND PL N APT 906",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337824631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23680 US 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651571",
            "telephone_number": "727-799-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Curlew Rd",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346981901",
            "country_code": "US",
            "telephone_number": "727-736-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABANCE",
        "first_name": "MARY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.