Individual provider Active NPI

Elizabeth Iocca Garcia, D.D.S

  • Dentist
  • Jackson, MI
National Provider Identifier
1023404209
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021984 Issued in MI
Practice address
2000 Spring Arbor Rd Ste a
Jackson, MI 49203-2887
Phone
(517) 787-5210
NPI assigned
Apr 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X KY
Dentist 122300000X 2901021984 MI Primary

Addresses

Primary practice location

2000 Spring Arbor Rd Ste a
Jackson, MI 49203-2887

Mailing address

2000 Spring Arbor Rd Ste a
Jackson, MI 49203-3693
Phone (517) 787-5210

Other practice location 1

4827 Stonewood Dr
Jackson, MI 49201-7902
Phone (517) 414-9024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20150904002128 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5496061459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021984MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Iocca Family Dentistry CurrentSince Aug 1, 2020 Accepting new patients
Iocca Family Dentistry Current Accepting new patients

Locations

2000 Spring Arbor Rd
Ste A
Jackson, MI 49203
Phone (517) 787-5210

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1023404209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SPRING ARBOR RD STE A",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033693",
            "telephone_number": "517-787-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SPRING ARBOR RD STE A",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032887",
            "telephone_number": "517-787-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4827 Stonewood Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492017902",
            "country_code": "US",
            "telephone_number": "517-414-9024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "ELIZABETH",
        "middle_name": "IOCCA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.