Active NPI
Elisa Carbonell Carmona
- General Practice Dentistry
- Hialeah, FL
National Provider Identifier
1649912429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN27596
- Practice address
- 395 W 49TH St Ste B
Hialeah, FL 33012-3715 - Phone
- (305) 351-3318
- NPI assigned
- Apr 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | DN27596 | FL | Primary |
Addresses
Primary practice location
395 W 49TH St Ste B
Hialeah, FL 33012-3715
Mailing address
2101 SW 83Rd Ave
Miami, FL 33155-1139
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 |
|---|---|---|---|
| DN27596 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1649912429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 SW 83RD AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331551139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "395 W 49TH ST STE B",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330123715",
"telephone_number": "305-351-3318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBONELL CARMONA",
"first_name": "ELISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-11",
"last_updated": "2023-07-27",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN27596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.