Mary Elizabeth Sorrentino, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401413259 Issued in VA

Practice address

340 Boatner Road
BLGD. 2751
Eglin Afb, FL 32542

Phone

(850) 883-8050

NPI assigned

Sep 20, 2011

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1346523974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 COMMONS DR W",
            "address_2": "APT 1308",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418484",
            "telephone_number": "757-375-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOATNER ROAD",
            "address_2": "BLGD. 2751",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "32542",
            "telephone_number": "850-883-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRENTINO",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Dee Smith, M.D.
• Sierra Smith, D.M.D.
• Stephanie Anne Smith
• Amy W Snow, R.PH.
• Airton D Soares, DDS
• William Craig Soucy, OTR/L
• Kayle Elizabeth Southerland, IDMT, USAF
• Nicole Lisa Sparks, PA-C
• Benjamin Parker Spires, M.D.
• Maria Stanek, CRNA

• Dentist in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.