Individual provider Active NPI

Ingrid Dooms, D.D.S.

  • General Practice Dentistry
  • Brandon, FL
National Provider Identifier
1801951546
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN9841 Issued in FL
Practice address
1749 S Kings Ave
Brandon, FL 33511-6220
Phone
(813) 661-1115
Fax
(813) 661-7771
NPI assigned
Dec 22, 2006
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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 DN9841 FL Primary

Addresses

Primary practice location

1749 S Kings Ave
Brandon, FL 33511-6220

Mailing address

1749 S Kings Ave
Brandon, FL 33511-6220
Phone (813) 661-1115

Other identifiers 1

IdentifierTypeStateIssuer
0774961-00MedicaidFL

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
DN9841FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1801951546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116220",
            "telephone_number": "813-661-1115",
            "fax_number": "813-661-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116220",
            "telephone_number": "813-661-1115",
            "fax_number": "813-661-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOMS",
        "first_name": "INGRID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0774961-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.