Active NPI
Katia Consuegra, DMD
- General Practice Dentistry
- Bonita Springs, FL
National Provider Identifier
1477107464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24474
- Practice address
- 26831 S Tamiami TRL Unit 48
Bonita Springs, FL 34134-7828 - Phone
- (239) 948-3200
- Fax
- (239) 948-3098
- NPI assigned
- Jul 28, 2019
- Last updated
- Jul 28, 2019
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24474 | FL | Primary |
Addresses
Primary practice location
26831 S Tamiami TRL Unit 48
Bonita Springs, FL 34134-7828
Mailing address
27174 Elaine Dr
Bonita Springs, FL 34135-6058
Phone (239) 273-5685
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190913000854 | FL | Order and Referring Only - Dentist | 6800125097 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24474 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564272000000",
"number": "1477107464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27174 ELAINE DR",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341356058",
"telephone_number": "239-273-5685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26831 S TAMIAMI TRL UNIT 48",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341347828",
"telephone_number": "239-948-3200",
"fax_number": "239-948-3098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONSUEGRA",
"first_name": "KATIA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-28",
"last_updated": "2019-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "24474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita Springs, FL
- Comfortable Care Dental Health Professionals, PA (A Beautiful Smile Dental Centre)
- Communi-K-Tions LLC
- Complete Home Care - Private Duty LLC
- Complete Practice Management Inc
- Haley Janet Connolly, AUD
- Charlton Cook, PH.D., N.D.
- Cora Health Services Inc (CORA Physical Therapy - Bonita Springs)
- Corrective Spinal Care of Florida 3, P.a. (Corrective Spinal Care of Florida)
- Julie Marie Cosmello, RPH
- Zahilyn Cote, L.M.T.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.