Individual provider Active NPI

Tessa Franchesca Scott, DMD

  • General Practice Dentistry
  • Opa Locka, FL
National Provider Identifier
1396821948
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16102 Issued in FL
Practice address
17301 NW 27TH Ave
Opa Locka, FL 33056-4001
Phone
(305) 624-1371
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN16102 FL Primary

Addresses

Primary practice location

17301 NW 27TH Ave
Opa Locka, FL 33056-4001

Mailing address

635 SW 113TH Way
Pembroke Pines, FL 33025-3440
Phone (954) 432-9456

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
I20160115000287 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335442912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN16102FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396821948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 SW 113TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330253440",
            "telephone_number": "954-432-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17301 NW 27TH AVE",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330564001",
            "telephone_number": "305-624-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "TESSA",
        "middle_name": "FRANCHESCA",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opa Locka, FL

Sources for this page

Verify at the official NPI Registry.