Individual provider Active NPI

Luis A Alicea, DMD

  • Prosthodontics
  • Tampa, FL
National Provider Identifier
1407947849
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN15801 Issued in FL
Practice address
4129 W Kennedy Blvd Ste 1
Tampa, FL 33609-2254
Phone
(813) 288-9700
Fax
(813) 639-0300
NPI assigned
Sep 28, 2006
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DN15801 FL Primary
Prosthodontics 1223P0700X 2460 PR

Addresses

Primary practice location

4129 W Kennedy Blvd Ste 1
Tampa, FL 33609-2254

Mailing address

4129 W Kennedy Blvd Ste 1
Tampa, FL 33609-2254
Phone (813) 288-9700

Other names 1

  • Luis Alicea-Sotomayor Former name

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

LicenseStateTypeSpecialty
2460PRMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Health Management PLLC Past Accepting new patients
Precision Dental Group LLC Past Accepting new patients
Adam Diasti DDS & Associates P.C. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1407947849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 W KENNEDY BLVD STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092254",
            "telephone_number": "813-288-9700",
            "fax_number": "813-639-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 W KENNEDY BLVD STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092254",
            "telephone_number": "813-288-9700",
            "fax_number": "813-639-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA",
        "first_name": "LUIS",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN15801",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PR",
            "license": "2460",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUIS",
            "last_name": "ALICEA-SOTOMAYOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.