Individual provider Active NPI

Paula Corinne De Freitas, DDS

  • Dentist
  • Hollywood, FL
National Provider Identifier
1356959399
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26298 Issued in FL
Practice address
1869 N 66TH Ave
Hollywood, FL 33024-4017
Phone
(954) 983-3992
NPI assigned
Jul 15, 2020
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN26298 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X DRPM2088 FL

Addresses

Primary practice location

1869 N 66TH Ave
Hollywood, FL 33024-4017

Mailing address

471 Ives Dairy Rd Apt 306
Miami, FL 33179-5423
Phone (651) 432-7095

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
DN26298FLMDDentist
DRPM2088FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1356959399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 IVES DAIRY RD APT 306",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331795423",
            "telephone_number": "651-432-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1869 N 66TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330244017",
            "telephone_number": "954-983-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FREITAS",
        "first_name": "PAULA",
        "middle_name": "CORINNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26298",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "DRPM2088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.