Active NPI
Shandra Figueroa
- Dentist
- Davenport, FL
National Provider Identifier
1467184671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN27496
- Practice address
- 1159 Posner Blvd
Davenport, FL 33837-3664 - Phone
- (863) 777-9890
- NPI assigned
- Jun 27, 2022
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN27496 | FL | Primary |
Addresses
Primary practice location
1159 Posner Blvd
Davenport, FL 33837-3664
Mailing address
4151 Big Valley Blvd
Kissimmee, FL 34746-3210
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 |
|---|---|---|---|
| DN27496 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davenport Modern Dentistry, PA | Dentist | Current | Accepting new patients |
Locations
1159 Posner Blvd
Davenport, FL 33837
Phone (863) 777-9890
Organizations & group practices 1
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": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1467184671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4151 BIG VALLEY BLVD",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347463210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1159 POSNER BLVD",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338373664",
"telephone_number": "863-777-9890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIGUEROA",
"first_name": "SHANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2022-08-31",
"certification_date": "2022-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN27496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, FL
- Ruby Dorone Fenn, P.T.
- Armando Fernandez Gonzalez, NP
- Daniela Fernandez Matos, RBT-24-343718
- Nashley Figueroa Rivera, MSW
- Lorena Mari Figueroa
- Finding Piece Behavior Therapy LLC
- Fines Enterprises, Inc (Tender Touch Health Care-Davenport, Fla)
- Shantele Fletcher, APRN, FNP-C
- Leonel Fleurimond, MSN, APRN, FNP-BC
- Florida Cancer Specialists & Research Institute, LLC (Florida Cancer Specialists)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.