Healthcare Provider Details

I. General information

NPI: 1538006085
Provider Name (Legal Business Name): JENNIFER FLORES PENA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1339 N SUMTER BLVD
NORTH PORT FL
34286-8072
US

IV. Provider business mailing address

8321 BELLA VISTA TER
FORT WASHINGTON MD
20744-5504
US

V. Phone/Fax

Practice location:
  • Phone: 941-941-7528
  • Fax:
Mailing address:
  • Phone: 240-502-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31523
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: