Individual provider Active NPI

Ana Sofia Cebollero, D.M.D.

  • Pediatric Dentistry
  • Tallahassee, FL
National Provider Identifier
1326417817
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
24371 Issued in FL
Practice address
1771 Capital Cir NE
Tallahassee, FL 32308-5517
Phone
(850) 765-3748
NPI assigned
Sep 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 24371 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1771 Capital Cir NE
Tallahassee, FL 32308-5517

Mailing address

237 John Knox Rd
Tallahassee, FL 32303-6676
Phone (850) 728-2167

Other practice location 1

237 John Knox Rd
Tallahassee, FL 32303-6676
Phone (850) 728-2167

Other practice location 2

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7174

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
24371FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tiny Smiles Pediatric Dentist PLLC Pediatric Dentistry CurrentSince Jul 13, 2025 Accepting new patients
Smileworks , PLLC Pediatric Dentistry CurrentSince Mar 6, 2022 Accepting new patients

Locations

1771 Capital Cir NE
Tallahassee, FL 32308
Phone (850) 765-3748

237 John Knox Rd
Tallahassee, FL 32303
Phone (850) 385-5565

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1326417817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 JOHN KNOX RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036676",
            "telephone_number": "850-728-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 CAPITAL CIR NE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085517",
            "telephone_number": "850-765-3748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "237 John Knox Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323036676",
            "country_code": "US",
            "telephone_number": "850-728-2167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "374 Stockholm St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374006",
            "country_code": "US",
            "telephone_number": "718-963-7174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEBOLLERO",
        "first_name": "ANA SOFIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "24371",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.