Individual provider Active NPI

Ashley Y. Canales Carmona, DDS

  • General Practice Dentistry
  • Brandon, FL
National Provider Identifier
1871018770
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN22843 Issued in FL
Practice address
313 S Lakewood Dr
Brandon, FL 33511-2815
Phone
(813) 653-6100
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 DN22843 FL Primary

Addresses

Primary practice location

313 S Lakewood Dr
Brandon, FL 33511-2815

Mailing address

313 S Lakewood Dr
Brandon, FL 33511-2815

Other practice location 1

14444 Beach Blvd Ste 2
Jacksonville, FL 32250-2010
Phone (904) 223-4939

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171012003317 FL Order and Referring Only - DentistPractitioner - Dentist 8729353024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN22843FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1871018770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 S LAKEWOOD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S LAKEWOOD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112815",
            "telephone_number": "813-653-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14444 Beach Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322502010",
            "country_code": "US",
            "telephone_number": "904-223-4939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANALES CARMONA",
        "first_name": "ASHLEY",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.