Individual provider Active NPI

Zulma Constanza Canola, DMD

  • Dentist
  • Delray Beach, FL
National Provider Identifier
1487942918
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 18678 Issued in FL
Practice address
5317 W Atlantic Ave
Suite 101
Delray Beach, FL 33484-8175
Phone
(561) 279-4080
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 18678 FL Primary

Addresses

Primary practice location

5317 W Atlantic Ave
Suite 101
Delray Beach, FL 33484-8175

Mailing address

1171 NW 106TH Ave
Plantation, FL 33322-7817
Phone (954) 554-6308

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314000383 FL Order and Referring Only - DentistPractitioner - Dentist 9436455722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 18678FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1487942918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 NW 106TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227817",
            "telephone_number": "954-554-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 W ATLANTIC AVE",
            "address_2": "SUITE 101",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848175",
            "telephone_number": "561-279-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANOLA",
        "first_name": "ZULMA",
        "middle_name": "CONSTANZA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 18678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.