Individual provider Active NPI

Gerald McElroy Kluft, D.D.S, F.I.C.D, PFA

  • Periodontics
  • Tampa, FL
National Provider Identifier
1013028075
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6516 Issued in FL
Practice address
5208 E Fowler Ave
Suite # F
Tampa, FL 33617-1906
Phone
(813) 988-1103
Fax
(813) 985-1524
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6516 FL Primary

Addresses

Primary practice location

5208 E Fowler Ave
Suite # F
Tampa, FL 33617-1906

Mailing address

5208 E Fowler Ave
Suite # F
Tampa, FL 33617-1906
Phone (813) 988-1103

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6516FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Periodontal Associates of Tampa Bay, P.a. Periodontics Past Accepting new patients
Gerald M. Kluft D.D.S. P.a. Periodontics PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013028075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 E FOWLER AVE",
            "address_2": "SUITE # F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171906",
            "telephone_number": "813-988-1103",
            "fax_number": "813-985-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 E FOWLER AVE",
            "address_2": "SUITE # F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171906",
            "telephone_number": "813-988-1103",
            "fax_number": "813-985-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUFT",
        "first_name": "GERALD",
        "middle_name": "MCELROY",
        "name_prefix": "Dr.",
        "credential": "D.D.S, F.I.C.D, PFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "6516",
            "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 9, 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.