Individual provider Active NPI

George Edward Hitzel, DDS

  • General Practice Dentistry
  • St Petersburg, FL
National Provider Identifier
1063545242
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN11998 Issued in FL
Practice address
6658 1St Ave S
St Petersburg, FL 33707-1320
Phone
(727) 384-6656
Fax
(727) 381-8252
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN11998 FL Primary

Addresses

Primary practice location

6658 1St Ave S
St Petersburg, FL 33707-1320

Mailing address

6658 1St Ave S
St Petersburg, FL 33707-1320
Phone (727) 384-6656

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
DN11998FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Champagne Dental Corp Past Accepting new patients
GD FL Champagne PLLC General Practice PastSince Nov 24, 2024 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063545242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6658 1ST AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071320",
            "telephone_number": "727-384-6656",
            "fax_number": "727-381-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6658 1ST AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071320",
            "telephone_number": "727-384-6656",
            "fax_number": "727-381-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITZEL",
        "first_name": "GEORGE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN11998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.