Active NPI
Suset Romano
- General Practice Dentistry
- Atlantic Beach, FL
National Provider Identifier
1750906293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN24890
- Practice address
- 1023 Atlantic Blvd
Atlantic Beach, FL 32233-3313 - Phone
- (904) 249-3104
- Fax
- (904) 249-3109
- NPI assigned
- Jun 10, 2020
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN24890 | FL | Primary |
Addresses
Primary practice location
1023 Atlantic Blvd
Atlantic Beach, FL 32233-3313
Mailing address
600 Technology Park Ste 101
Lake Mary, FL 32746-7122
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 |
|---|---|---|---|
| DN24890 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1750906293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 TECHNOLOGY PARK STE 101",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327467122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1023 ATLANTIC BLVD",
"city": "ATLANTIC BEACH",
"state": "FL",
"postal_code": "322333313",
"telephone_number": "904-249-3104",
"fax_number": "904-249-3109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMANO",
"first_name": "SUSET",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-10",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN24890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlantic Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.