Johana Kutrolli, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN24526 Issued in FL

Practice address

1415 Governors Square Blvd
Tallahassee, FL 32301-3049

Phone

(850) 688-9095

NPI assigned

Aug 14, 2019

Last updated

Aug 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

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.

• Newark Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1740345693
  Medicare reassignment NPD
• Newark Community Health Centers, Inc

  dba Ironbound Medical & Dental Center

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1366993586
  NPD
• BWM Dentistry PA

  • General Practice Dentistry
  • Tallahassee, FL
  • NPI 1447753090
  NPD (past)

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1780230896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 GOVERNORS SQUARE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013049",
            "telephone_number": "718-350-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 GOVERNORS SQUARE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013049",
            "telephone_number": "850-688-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTROLLI",
        "first_name": "JOHANA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dina Makram Kurdi
• Sereena Makram Kurdi
• Jenae Anne Kurn, RDN, LDN
• Roopashri G Kurse, M.D.
• Kit D Kuss, MD
• Angelina Alexeevna Kuzina, MD
• Jodi L'Heureux, FNP
• La Grand Belle Estates
• La Grande Belle Estates
• Laboratory Corporation of America

• Dentist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.