Individual provider Active NPI

Paola Carolina Alvarez Mora, DDS

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1306421938
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN28372 Issued in FL
Practice address
5316 Central Florida Pkwy
Orlando, FL 32821-8772
Phone
(407) 239-9557
Fax
(407) 917-8661
NPI assigned
Mar 15, 2021
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN28372 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X 13082 CT

Addresses

Primary practice location

5316 Central Florida Pkwy
Orlando, FL 32821-8772

Mailing address

3989 Spartina Way
Orlando, FL 32824-7876
Phone (407) 881-2904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20210709001298 CT Order and Referring Only - DentistPractitioner - Dentist 3173925328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN28372FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1306421938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3989 SPARTINA WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328247876",
            "telephone_number": "407-881-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 CENTRAL FLORIDA PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328218772",
            "telephone_number": "407-239-9557",
            "fax_number": "407-917-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ MORA",
        "first_name": "PAOLA",
        "middle_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28372",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "13082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.