LAUREN LOURDES MANTILLA
NPI 1205682978
Dentist in Miami, FL

Q: What is Lauren Mantilla's NPI number?

The NPI number for Lauren Mantilla is 1205682978. It was assigned to this individual provider in the NPPES registry on April 24, 2024.

Q: What is Lauren Mantilla's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Lauren Mantilla was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 24, 2024PECOS Enrolled

5607 NW 27TH AVE STE 2, MIAMI, FL 33142(305) 637-6400(305) 636-5155 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 3, 2025, Apr 24, 2024 (2 updates tracked since 2024).

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About Lauren Lourdes Mantilla NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAUREN LOURDES MANTILLA (NPI 1205682978) is an individual dentist in Miami, Florida, licensed in Florida (DN29089) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS and is a graduate of Howard University College Of Dentistry (2024).

NPPES Registry Identity

NPI1205682978

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameLAUREN LOURDES MANTILLA

Location Address5607 NW 27TH AVE STE 2Miami, FL 33142-2826

Mailing Address5607 Nw 27th Ave Ste 1Miami, FL 33142-2826 · (305) 805-1700 · Fax (305) 805-1715

Phone(305) 637-6400

Fax(305) 636-5155

Sole ProprietorYes

Medical School CMSHoward University College Of DentistryGraduated 2024

Enumeration DateApril 24, 2024

Last NPPES UpdateSeptember 3, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2025

✔ NPI 1205682978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in FL · DN29089

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

5607 NW 27TH AVE STE 2, Miami, FL 33142

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lauren Lourdes Mantilla is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880190610

PECOS Enrollment IDI20251001001328

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lauren Mantilla reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jessie Trice Community Health System Inc

Same address

Federally Qualified Health Center (FQHC)

5607 NW 27TH AVE STE 2
Miami, FL 33142

Reassigned Medicare billing, Florida enrollment
61 clinicians in this Medicare group

NPI 1760645550 (305) 637-6400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33142 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.13 typical visit price

range $60.92 – $187.05

Typical copayment $24.03 (range $15.23 – $46.76)

Most-billed visit code 99203

Established Patient

$75.86 typical visit price

range $18.99 – $150.24

Typical copayment $18.96 (range $4.74 – $37.56)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LASHUNDA COLLINS DDS

Dentist