MEDICARE: SMILE PLUS DENTAL GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1295682284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE PLUS DENTAL GROUP INC

Provider Business Mailing Address
First Line	:	4200 W CYPRESS ST STE 690
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4112
Country	:	US
Telephone Number	:	813-690-0666
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 US HIGHWAY 98
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-6574
Country	:	US
Telephone Number	:	813-690-0666
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VIVIENNE MARIE LUGO GONZALEZ
Credential	:	DMD
Telephone Number	:	813-690-0666

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

Similar Medicare Providers

1578002903 — JOHAN VARGAS M.D.
Practice Location Address:

1421 BARTOW RD
LAKELAND, FL
33801-6574

Practice Phone: 813-499-1500
Practice Fax: 813-213-0440

1538825609 — CANO HEALTH, LLC
Practice Location Address:

1421 US HIGHWAY 98
LAKELAND, FL
33801-6574

Practice Phone: 855-226-6633
Practice Fax:

1528797776 — ANGELO PEREIRA DMD
Practice Location Address:

1421 BARTOW RD
LAKELAND, FL
33801-6574

Practice Phone: 855-552-5355
Practice Fax:

1932944949 — DEVORIA THOMAS
Practice Location Address:

1439 BARTOW RD # 113
LAKELAND, FL
33801-6574

Practice Phone: 863-370-7965
Practice Fax:

1801628128 — HUMANITARY MEDICAL CENTER LAKELAND, INC
Practice Location Address:

1421 BARTOW RD
LAKELAND, FL
33801-6574

Practice Phone: 813-499-1500
Practice Fax: 813-499-1499

1497552483 — ALFREDO DENIS LOPEZ MACEDA
Practice Location Address:

1421 BARTOW RD
LAKELAND, FL
33801-6574

Practice Phone: 813-499-0197
Practice Fax:

Directions to “SMILE PLUS DENTAL GROUP INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.