Active NPI
Alyssa Grace Gonzalez Cabanas, DMD
- Dentist
- Pompano Beach, FL
National Provider Identifier
1679134142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24348
- Practice address
- 161 S Pompano Pkwy
Pompano Beach, FL 33069-3003 - NPI assigned
- Jun 25, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 24348 | FL | Primary |
Addresses
Primary practice location
161 S Pompano Pkwy
Pompano Beach, FL 33069-3003
Mailing address
2901 SW 22ND Cir # 42C
Delray Beach, FL 33445-7859
Phone (786) 374-7224
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190917003735 | FL | Order and Referring Only - Dentist | 1254661259 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24348 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1679134142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 SW 22ND CIR # 42C",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334457859",
"telephone_number": "786-374-7224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 S POMPANO PKWY",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330693003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ CABANAS",
"first_name": "ALYSSA",
"middle_name": "GRACE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-25",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "24348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.