Healthcare Provider Details

I. General information

NPI: 1689093767
Provider Name (Legal Business Name): ANGELINA M ADAMES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELINA MIOSOTIS GOMEZ TEJADA DDS

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 US HIGHWAY 98 N
LAKELAND FL
33809-3108
US

IV. Provider business mailing address

10065 NW 46TH ST APT 204
DORAL FL
33178-2284
US

V. Phone/Fax

Practice location:
  • Phone: 863-221-8752
  • Fax:
Mailing address:
  • Phone: 907-544-6205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number058293-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN21119
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 21119
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDN21119
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: