Active NPI
Ingrid Luz Medina, DDS
- Dentist
- Belleview, FL
National Provider Identifier
1922233550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 18625
- Practice address
- 5927 SE Babb Rd
Belleview, FL 34420-4105 - Phone
- (352) 245-9184
- NPI assigned
- May 27, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 18625 | FL | Primary |
Addresses
Primary practice location
5927 SE Babb Rd
Belleview, FL 34420-4105
Mailing address
1309 SE 37TH Ave
Ocala, FL 34471-4962
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18625 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CDPG, P.L. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Belleview, FL
- NPI 1851052617
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1922233550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 SE 37TH AVE",
"city": "OCALA",
"state": "FL",
"postal_code": "344714962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5927 SE BABB RD",
"city": "BELLEVIEW",
"state": "FL",
"postal_code": "344204105",
"telephone_number": "352-245-9184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "INGRID",
"middle_name": "LUZ",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "18625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.