Individual provider Active NPI

Royce Anthony Garmo, DDS

  • Dentist
  • Jackson, MS
National Provider Identifier
1023851540
Registry record updated Jul 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111342 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-6090
NPI assigned
Jun 13, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901602042 MI
Dentist 122300000X 111342 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

6426 Charles Dr
West Bloomfield, MI 48322-4402
Phone (248) 408-6711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240708003555 MI Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Dentist 1153866785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901602042MIMDDentist
111342MSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752364800000",
    "number": "1023851540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6426 CHARLES DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224402",
            "telephone_number": "248-408-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARMO",
        "first_name": "ROYCE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-07-13",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602042",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "111342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.