Individual provider Active NPI

Codrina Alexandra Baston Geriguis, DDS

  • General Practice Dentistry
  • Titusville, FL
National Provider Identifier
1013778992
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109604 Issued in CA
Practice address
2670 Garden St
Titusville, FL 32796-3176
Phone
(321) 267-1526
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 109604 CA Primary

Addresses

Primary practice location

2670 Garden St
Titusville, FL 32796-3176

Mailing address

9304 Moss Preserve Pkwy Apt 306
Orlando, FL 32832-6726
Phone (760) 805-4588

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109604CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1013778992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 MOSS PRESERVE PKWY APT 306",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326726",
            "telephone_number": "760-805-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963176",
            "telephone_number": "321-267-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERIGUIS",
        "first_name": "CODRINA",
        "middle_name": "ALEXANDRA BASTON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.