Individual provider Active NPI

Dana B. Cuculici, DMD

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1992744205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13667 Issued in FL
Practice address
4917 Ehrlich Rd
Suite 100
Tampa, FL 33624-2005
Phone
(813) 264-6911
Fax
(813) 961-6338
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13667 FL Primary

Addresses

Primary practice location

4917 Ehrlich Rd
Suite 100
Tampa, FL 33624-2005

Mailing address

4917 Ehrlich Rd
Suite 100
Tampa, FL 33624-2005
Phone (813) 264-6911

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

LicenseStateTypeSpecialty
13667FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992744205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 EHRLICH RD",
            "address_2": "SUITE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242005",
            "telephone_number": "813-264-6911",
            "fax_number": "813-961-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 EHRLICH RD",
            "address_2": "SUITE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242005",
            "telephone_number": "813-264-6911",
            "fax_number": "813-961-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCULICI",
        "first_name": "DANA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "13667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.