Lourdes Basulto, D.A

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

DR134398 Issued in FL

Practice address

4410 W 16TH Ave Ste 52
Hialeah, FL 33012-7193

Phone

(305) 825-9899

Fax

(305) 825-9858

NPI assigned

Mar 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1942835574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 W 16TH AVE STE 52",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127193",
            "telephone_number": "305-825-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 W 16TH AVE STE 52",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127193",
            "telephone_number": "305-825-9899",
            "fax_number": "305-825-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASULTO",
        "first_name": "LOURDES",
        "credential": "D.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Assistant",
            "state": "FL",
            "license": "DR134398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@acpediatricdentistry.com",
            "affiliation": "N",
            "endpointDescription": "contact@acpediatricdentistry.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4410 W 16th Ave Ste 52",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330127193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rivazzelly Bastardo, PTA
• Gabriela Baster
• Daylis Basulto Romero
• Katya Guadalupe Basulto Sanchez
• Janisset Basulto, FNP, APRN
• Lazaro A Batan Valdes
• Norge Batista Albuerne
• Yismelis Batista Cabezas
• Liane Batista CHI
• Osnilda Batista Diaz

• Dental Assistant in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Dental Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.