Manuel A Pulido, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17965 Issued in FL

Practice address

4161 Tamiami Trail, Suite 604
Port Charlotte, FL 33948

Phone

(941) 255-8500

Fax

(941) 255-8503

NPI assigned

Jun 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407050909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7507 NW 18TH DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330241011",
            "telephone_number": "954-319-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 TAMIAMI TRAIL, SUITE 604",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-255-8500",
            "fax_number": "941-255-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULIDO",
        "first_name": "MANUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.