Active NPI
Eleanor Rebecca Apodaca, DDS
- Endodontics
- Lutz, FL
National Provider Identifier
1467655209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN10238
- Practice address
- 17521 N. Dale Mabry Hwy.
Lutz, FL 33548-4521 - Phone
- (813) 908-3636
- Fax
- (813) 908-7668
- NPI assigned
- Jun 8, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN10238 | FL | Primary |
Addresses
Primary practice location
17521 N. Dale Mabry Hwy.
Lutz, FL 33548-4521
Mailing address
17521 N. Dale Mabry Hwy.
Lutz, FL 33548-4521
Phone (813) 908-3636
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 |
|---|---|---|---|
| DN10238 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467655209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17521 N. DALE MABRY HWY.",
"city": "LUTZ",
"state": "FL",
"postal_code": "335484521",
"telephone_number": "813-908-3636",
"fax_number": "813-908-7668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17521 N. DALE MABRY HWY.",
"city": "LUTZ",
"state": "FL",
"postal_code": "335484521",
"telephone_number": "813-908-3636",
"fax_number": "813-908-7668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "APODACA",
"first_name": "ELEANOR",
"middle_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN10238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- 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.