Individual provider Active NPI

Catalina Botero, D.D.S.

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1659513380
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18899 Issued in FL
Practice address
12950 Race Track Rd Ste 109
Tampa, FL 33626-1304
Phone
(813) 803-3355
Fax
(813) 213-4736
NPI assigned
Mar 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN18899 FL Primary

Addresses

Primary practice location

12950 Race Track Rd Ste 109
Tampa, FL 33626-1304

Mailing address

12950 Race Track Rd Ste Suite109
Tampa, FL 33626-1309
Phone (813) 803-3355

Other practice location 1

7918 Land O Lakes Blvd Ste 101
Land O Lakes, FL 34638-5703
Phone (719) 289-1799

Other practice location 2

2603 Vinewood Ln
Pueblo, CO 81005-3370
Phone (719) 564-6464

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

LicenseStateTypeSpecialty
DN18899FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Li'L Sunshine Smiles Dentistry P.a CurrentSince Mar 20, 2022 Accepting new patients

Locations

12950 Race Track Rd
Ste 109
Tampa, FL 33626
Phone (719) 289-1799

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12589/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1659513380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 RACE TRACK RD STE SUITE109",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261309",
            "telephone_number": "813-803-3355",
            "fax_number": "813-213-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 RACE TRACK RD STE 109",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261304",
            "telephone_number": "813-803-3355",
            "fax_number": "813-213-4736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7918 Land O Lakes Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346385703",
            "country_code": "US",
            "telephone_number": "719-289-1799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2603 Vinewood Ln",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810053370",
            "country_code": "US",
            "telephone_number": "719-564-6464",
            "fax_number": "719-564-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "CATALINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-26",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.