Nicole Elizabeth Decambra, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN 20562 Issued in FL

Practice address

10924 Cross Creek Blvd
Tampa, FL 33647-4034

Phone

(813) 982-1777

Fax

(813) 986-6230

NPI assigned

Jul 3, 2013

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 FL

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

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1790125821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10924 CROSS CREEK BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336474034",
            "telephone_number": "813-982-1777",
            "fax_number": "813-986-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10924 CROSS CREEK BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336474034",
            "telephone_number": "813-982-1777",
            "fax_number": "813-986-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECAMBRA",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.