Jamie W Odom, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15466 Issued in FL

Practice address

28029 Hwy 27
Dundee, FL 33838-4276

Phone

(863) 439-2911

NPI assigned

Oct 31, 2006

Last updated

Jan 9, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1013093210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28029 HWY 27",
            "city": "DUNDEE",
            "state": "FL",
            "postal_code": "338384276",
            "telephone_number": "863-439-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28029 HWY 27",
            "city": "DUNDEE",
            "state": "FL",
            "postal_code": "338384276",
            "telephone_number": "863-439-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "JAMIE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "15466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobility Express of Dundee
• Mondello Family Clinic PA
• Christopher G Mondello, D.O.
• Nelson Roberto Marques DDS PA
• Cara R Nelson-James, DO
• Chinwe Ohanu, MD
• Yosmy Michelle Paredes-Pinerez
• Rasiel Perez Castillo
• Lisa Marie Perkins, FNP-BC
• Jasmine Nicole Poole, MS

• General Practice Dentistry in Dundee, FL
• Providers in Dundee, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.