Active NPI
Yamilet Pena
- Dental Hygienist
- Winter Haven, FL
National Provider Identifier
1396200374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH22110
- Practice address
- 201 Magnolia Ave SW
Winter Haven, FL 33880-2943 - Phone
- (863) 229-7950
- NPI assigned
- Feb 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH22110 | FL | Primary |
Addresses
Primary practice location
201 Magnolia Ave SW
Winter Haven, FL 33880-2943
Mailing address
47 5TH St NW
Winter Haven, FL 33881-4672
Phone (863) 291-5110
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
| License | State | Type | Specialty |
|---|---|---|---|
| DH22110 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1396200374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 5TH ST NW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814672",
"telephone_number": "863-291-5110",
"fax_number": "863-268-7899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 MAGNOLIA AVE SW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338802943",
"telephone_number": "863-229-7950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "YAMILET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-05",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH22110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.