Simona Ivanov, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN23345 Issued in FL

Practice address

302 W Fletcher Ave
Tampa, FL 33612

Phone

(813) 866-0930

Fax

(813) 405-3722

NPI assigned

Jun 25, 2018

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

Specialty

Dentist

Education

University of Minnesota School of Dentistry, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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 and National Provider Directory roles.

• Tampa Family Health Centers Inc

  • Multi-Specialty Clinic/Center
  • Tampa, FL
  • NPI 1356347413
  Medicare reassignment
• Tampa Family Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Tampa, FL
  • NPI 1831655380
  NPD
• Tampa Family Health Centers, Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1831769579
  NPD
• Virginia M. Melmed, D.D.S., P.a.

  • General Practice Dentistry
  • Clearwater, FL
  • NPI 1124728753
  NPD (past)

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1861987752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123415",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1243 Lakeview Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337563587",
            "country_code": "US",
            "telephone_number": "727-443-7353",
            "fax_number": "727-443-2144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "SIMONA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN23345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Its Jazzy Salo
• Joanna Itwaru
• Joy R Iurato, CPO/L
• IV League Hydration Therapy LLC
• Bogdan Konstantinov Ivanov, D.M.D.
• Stanislav Asenov Ivanov, MD
• Joyce Iverson, SLP
• Vannessa Ivery, PSY.S.
• Carol A Ives, ARNP
• Daniela Ivey

• Public Health Dentistry in Tampa, FL
• Providers in Tampa, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.