Pablo J Sierra-Duque, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN17835 Issued in FL

Practice address

111 Lagrande Blvd
Lady Lake, FL 32159-1302

Phone

(352) 753-7507

Fax

(352) 753-5079

NPI assigned

Dec 28, 2006

Last updated

Apr 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Practice roles

Networks

• Freedom Health HMO Network

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.

• Citrus Dental Sleep Medicine, PA

  dba Dental Sleep Solutions, LLC

  • Dentist
  • Inverness, FL
  • NPI 1285981415
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1841356847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1900",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321581900",
            "telephone_number": "352-753-7507",
            "fax_number": "352-753-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAGRANDE BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321591302",
            "telephone_number": "352-753-7507",
            "fax_number": "352-753-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA-DUQUE",
        "first_name": "PABLO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17835",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "7545",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janmejay Shaktawat, M.D.
• Shannon Floyd DPM PA
• Shantinath Villages Pulmonary and Sleep Center PLLC
• Kayla Marcia Sheffield, PHARMD, RPH
• Brian Shin, DDS
• Shane E Sikes, DC
• Donna Isadora Silver, LMHC, CAP
• Dannielle Silvis
• Kalena Kidd Singleton, LMT
• Smirnoff Neurology PA (Village Neurology Center)

• Dentist in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.