Active NPI
Janine K Cornelius, DDS
- Periodontics
- Tampa, FL
National Provider Identifier
1023148244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN12140
- Practice address
- 3317 W Mullen Ave
Tampa, FL 33609-4657 - Phone
- (813) 382-4630
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12140 | FL | |
| Periodontics | 1223P0300X | DN12140 | FL | Primary |
Addresses
Primary practice location
3317 W Mullen Ave
Tampa, FL 33609-4657
Mailing address
3317 W Mullen Ave
Tampa, FL 33609-4657
Phone (813) 382-4630
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12140 | FL | MD | Chiropractor |
| DN12140 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1023148244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3317 W MULLEN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336094657",
"telephone_number": "813-382-4630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3317 W MULLEN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336094657",
"telephone_number": "813-382-4630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNELIUS",
"first_name": "JANINE",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "12140",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN12140",
"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 Jan 14, 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.