Michelle Martinez Sarasola, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18426 Issued in FL

Practice address

3217 SW Port St. Lucie Blvd
Port St. Lucie, FL 34953

Phone

(772) 871-9456

Fax

(772) 871-9422

NPI assigned

Apr 23, 2010

Sex

Female

Sole proprietor

Yes

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1346567856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 SW PORT ST. LUCIE BLVD",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-871-9456",
            "fax_number": "772-871-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 SW PORT ST. LUCIE BLVD",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-871-9456",
            "fax_number": "772-871-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARASOLA",
        "first_name": "MICHELLE",
        "middle_name": "MARTINEZ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Port St Lucie, FL
• Providers in Port St Lucie, 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 12, 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.