Active NPI
Luis Carrero
- General Practice Dentistry
- Riverview, FL
National Provider Identifier
1487765400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN16948
- Practice address
- 11278 Sullivan St
Riverview, FL 33578-2140 - Phone
- (813) 436-9813
- Fax
- (813) 436-9817
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- 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 | DN16948 | FL | Primary |
Addresses
Primary practice location
11278 Sullivan St
Riverview, FL 33578-2140
Mailing address
11278 Sullivan St
Riverview, FL 33578-2140
Phone (813) 436-9813
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 |
|---|---|---|---|
| DN16948 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1487765400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11278 SULLIVAN ST",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335782140",
"telephone_number": "813-436-9813",
"fax_number": "813-436-9817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11278 SULLIVAN ST",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335782140",
"telephone_number": "813-436-9813",
"fax_number": "813-436-9817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRERO",
"first_name": "LUIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN16948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.