Dental Associates of Florida (Lutz), PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL ASSOCIATES OF FLORIDA (LUTZ), PLLC

Practice address

23641 State Road 54
Lutz, FL 33559-7306

Phone

(813) 343-4649

NPI assigned

Jan 22, 2019

Organization subpart

No

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

Authorized official

Name

Stephanie Gomez

Title

Credentialing Supervisor

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1861956070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23641 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597306",
            "telephone_number": "813-343-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23641 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597306",
            "telephone_number": "813-343-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES OF FLORIDA (LUTZ), PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Joyce Delorenzo
• Joseph Anthony Delosreyes Jr., RPH
• Vivian C Deluca, DMD
• James Salvatore Demauro, LCSW
• Emily Caroline Denisco, APRN,FNP-C
• Dental Care of Vandyke Inc
• Dental House LLC
• Amanda Gray Depippo, LMHC, CAP
• Taras Deputat
• Desai Surgical Care

• Dental Clinic/Center in Lutz, FL
• Providers in Lutz, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.