Individual provider Active NPI

George F Estrada, D.M.D.

  • Dentist
  • Loxahatchee, FL
National Provider Identifier
1952493694
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN11589 Issued in FL
Practice address
13005 Southern Blvd
Suite 114
Loxahatchee, FL 33470-9206
Phone
(561) 793-4477
NPI assigned
Sep 29, 2006
Last updated
Oct 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN11589 FL Primary

Addresses

Primary practice location

13005 Southern Blvd
Suite 114
Loxahatchee, FL 33470-9206

Mailing address

13005 Southern Blvd
Suite 114
Loxahatchee, FL 33470-9206
Phone (561) 793-4477

Other identifiers 1

IdentifierTypeStateIssuer
64642OtherFLBLUECROSS BLUE SHIELD OF IL

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
I20160831000150 FL Order and Referring Only - DentistPractitioner - Dentist 7517253537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN11589FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Zinnia Sotolongo DMD PA PastSince Oct 6, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1952493694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE 114",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-793-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE 114",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-793-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "GEORGE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD OF IL",
            "identifier": "64642",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loxahatchee, FL

Sources for this page

Verify at the official NPI Registry.