Nelson Martin Gumucio, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN9221 Issued in FL

Practice address

13005 Southern Blvd
Suite # 143
Loxahatchee, FL 33470-9206

Phone

(561) 790-5414

Fax

(561) 790-1052

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kiren George DMD PA

  dba Vision Dental

  • Dental Clinic/Center
  • Loxahatchee, FL
  • NPI 1407547417
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306902325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE # 143",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-790-5414",
            "fax_number": "561-790-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE # 143",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-790-5414",
            "fax_number": "561-790-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMUCIO",
        "first_name": "NELSON",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheri Shannon Grisso, ARNP
• Growing Hearts Inc
• Gsareen, LLC., (Serentity by a. Dr. Sareen)
• Roberto Andres Guerrero, M.D.
• Susan E Guinan
• Kimberly K Gunn, ARNP
• Mercedes Gutierrez Pardo
• Stefan Alin Hall
• Diana May Hanson, CRT
• Matthew Hanson

• General Practice Dentistry in Loxahatchee, FL
• Providers in Loxahatchee, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.