Individual provider Active NPI

Sandra Bernaza, DMD

  • General Practice Dentistry
  • Miramar, FL
National Provider Identifier
1598323958
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN24142 Issued in FL
Practice address
12621 Miramar Pkwy Bay 102
Miramar, FL 33027-2910
Phone
(954) 621-1496
NPI assigned
May 31, 2019
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24142 FL
General Practice Dentistry 1223G0001X DN24142 FL Primary

Addresses

Primary practice location

12621 Miramar Pkwy Bay 102
Miramar, FL 33027-2910

Mailing address

4290 SW 139TH Ave
Miramar, FL 33027-3026

Other practice location 1

305 SW Pine Island Rd Unit 1
Cape Coral, FL 33991-2044
Phone (786) 333-2065

Other practice location 2

8180 NW 155th St # 200
Miami Lakes, FL 33016-5871
Phone (305) 512-9250

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
I20250804001847 FL Order and Referring Only - DentistPractitioner - Dentist 3971011719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Miramar Modern Dentistry, PA General Practice CurrentSince Jun 15, 2025 Accepting new patients
Lazaro Fernandez D.D.S. P.a. Dentist PastSince Nov 1, 2020 Accepting new patients

Locations

12621 Miramar Pkwy
#102
Miramar, FL 33027
Phone (954) 621-1496

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1598323958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 SW 139TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12621 MIRAMAR PKWY BAY 102",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272910",
            "telephone_number": "954-621-1496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 SW Pine Island Rd Unit 1",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339912044",
            "country_code": "US",
            "telephone_number": "786-333-2065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8180 NW 155th St # 200",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330165871",
            "country_code": "US",
            "telephone_number": "305-512-9250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNAZA",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24142",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.