Active NPI
Jonathan Colucci
- Dentist
- Winter Haven, FL
National Provider Identifier
1982229613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN24950
- Practice address
- 1425 6TH St NW
Winter Haven, FL 33881-2365 - Phone
- (863) 269-0153
- NPI assigned
- Jun 9, 2020
- Sex
- Male
- 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 | DN24950 | FL | Primary |
Addresses
Primary practice location
1425 6TH St NW
Winter Haven, FL 33881-2365
Mailing address
1425 6TH St NW
Winter Haven, FL 33881-2365
Phone (863) 269-0153
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 |
|---|---|---|---|
| DN24950 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comfortable Care Dental Health Professionals, P.a. | Current | Accepting new patients | |
| Jonathan Colucci DMD PLLC | Current | Accepting new patients |
Locations
1425 6th St NW
Winter Haven, FL 33881
Phone (863) 269-0153
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Public Health Dentistry
- Tampa, FL
- NPI 1023848256
-
- General Practice Dentistry
- Winter Haven, FL
- NPI 1730705419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1982229613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 6TH ST NW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338812365",
"telephone_number": "863-269-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 6TH ST NW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338812365",
"telephone_number": "863-269-0153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLUCCI",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-09",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN24950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
- Trevon Lamar Coleman
- Colleen Adult Family Care Home
- David Collins Jr., MD
- Angela Maria Colon Santiago, M.D
- Solimar Colon-Ortiz, LMHC
- Caroline Grace Combs, PA-C
- Comfortable Care Dental Health Professionals, P.a.
- Comfortable Care Dental Health Professionals, P.a.
- Comfortable Care Dental Health Professionals, P.a.
- Sharon M Comkowycz, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.