NPIMap

Organization Active NPI

Smile Designs by Dr. Charlotte Gerry L/O

  • General Practice Dentistry
  • Live Oak, FL
National Provider Identifier
1104090943
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14223 Issued in FL
Legal business name
SMILE DESIGNS BY DR. CHARLOTTE GERRY L/O
Practice address
530 Howard St E
Live Oak, FL 32064-3306
Phone
(386) 362-6800
Fax
(386) 364-5199
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Dr. Charlotte Y Gerry, D.M.D.
Title
President
Phone
(386) 362-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN14223 FL Primary

Addresses

Primary practice location

530 Howard St E
Live Oak, FL 32064-3306

Mailing address

530 Howard St E
Live Oak, FL 32064-3306
Phone (386) 362-6800

National Provider Directory

National Provider Directory
Tax ID family
Smile Designs by Charlotte Gerry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

530 Howard St E
Live Oak, FL 32064
Phone (386) 362-6800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1104090943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 HOWARD ST E",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643306",
            "telephone_number": "386-362-6800",
            "fax_number": "386-364-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 HOWARD ST E",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643306",
            "telephone_number": "386-362-6800",
            "fax_number": "386-364-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DESIGNS BY DR. CHARLOTTE GERRY L/O",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "GERRY",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-362-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.