Stephanie M. Acevedo-Decandis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN19360 Issued in FL

Practice address

14444 Beach Blvd Ste 2
Jacksonville, FL 32250-1587

Phone

(904) 223-4939

NPI assigned

Jun 13, 2011

Sex

Female

Sole proprietor

No

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.

Medicare enrollment (NPD)

Enrolled

• Stephanie M. Acevedo Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 3, 2015.

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1962797498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 GREAT POND DR STE 2002",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14444 BEACH BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501587",
            "telephone_number": "904-223-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO-DECANDIS",
        "first_name": "STEPHANIE",
        "middle_name": "M.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ACEVEDO",
            "middle_name": "M.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jellie Acedo, REGISTERED NURSE
• Jazmin Aileen Acero
• Hiram Alejandro Acevedo Bonilla, MD
• Michael Anthony Acevedo Monsanto Jr., MD
• Daniel Jose Acevedo Velez, PA
• Jason Acevedo, PHARMD
• Jorge I Acevedo, M.D.
• Premal Shobhan Acharya, DO
• Viral Acharya, MD
• Achieve Physical Therapy Limited Partnership

• All providers in Jacksonville, FL
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.