Individual provider Active NPI

Renata Cunha, DDS

  • General Practice Dentistry
  • Pompano Beach, FL
National Provider Identifier
1366761389
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
FC DN 19528 Issued in FL
Practice address
1990 N Federal Hwy Ste B
Pompano Beach, FL 33062-1032
Phone
(954) 840-6619
Fax
(754) 220-6054
NPI assigned
Jun 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60156700 WA
General Practice Dentistry 1223G0001X FC DN 19528 FL Primary

Addresses

Primary practice location

1990 N Federal Hwy Ste B
Pompano Beach, FL 33062-1032

Mailing address

1990 N. Federal Hwy #B
Pompano Beach, FL 33062
Phone (954) 840-6619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608001191 FL Order and Referring Only - DentistPractitioner - Dentist 1052601705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FC DN 19528FLMDGeneral Practice Dentistry
DE60156700WAMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1366761389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 N. FEDERAL HWY #B",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "33062",
            "telephone_number": "954-840-6619",
            "fax_number": "754-220-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 N FEDERAL HWY STE B",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330621032",
            "telephone_number": "954-840-6619",
            "fax_number": "754-220-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNHA",
        "first_name": "RENATA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60156700",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "FC DN 19528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.