Carolina Haber Florencio, DMD, PHD

Primary specialty

DentistTaxonomy code 122300000X

License

DE60659486 Issued in WA

Practice address

11216 NE 15TH St
Ste B
Bellevue, WA 98004-3723

Phone

(425) 451-8611

NPI assigned

Aug 8, 2016

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

Other identifiers 2

Other names 1

• Carolina Florencio Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 28, 2016 through Nov 28, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1386198331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4603 168TH CT NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525448",
            "telephone_number": "425-420-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 NE 15TH ST",
            "address_2": "STE B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043723",
            "telephone_number": "425-451-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENCIO",
        "first_name": "CAROLINA",
        "middle_name": "HABER",
        "name_prefix": "Dr.",
        "credential": "DMD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60659486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2- CAROLINA FLORENCIO/BELLEVUE TULIP DENTAL",
            "identifier": "1831642255",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE2- DR ALAN NOHR &ASSOCIATES",
            "identifier": "1093166563",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINA",
            "last_name": "FLORENCIO",
            "credential": "DMD, PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Bellevue, WA
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.