Hetienne Mota Macedo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28713 Issued in FL

Practice address

690 Goodlette-Frank Rd N
Naples, FL 34102-5613

Phone

(239) 263-1151

NPI assigned

Dec 7, 2023

Last updated

Dec 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Park Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Naples, FL
  • NPI 1861739179
  NPD (past)

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1346017514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 LE MARC CT",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 GOODLETTE-FRANK RD N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025613",
            "telephone_number": "239-263-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTA MACEDO",
        "first_name": "HETIENNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28713",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Moser, LCSW, ACHP-SW
• Delaney Moser
• Mary Jean Moses, DC PA
• Vadim Mosiychuk, CRNA
• Pedro Mostafa, ARNP
• Mother's Pharmacy
• Alicia Weldon Motley, RPH
• Arthur Douglas Motley Jr., RPH
• Jeffrey Glenn Moulton, M.S., CCC-SLP
• Lauren Moulton

• General Practice Dentistry in Naples, FL
• Providers in Naples, 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 Dec 7, 2023; 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.