Active NPI
Mikhail M Gankin, DMD
- Endodontics
- Tampa, FL
National Provider Identifier
1114112935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN20550
- Practice address
- 808 N Franklin St
#2801
Tampa, FL 33602-3859 - Phone
- (323) 868-6670
- NPI assigned
- Sep 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN20550 | FL | Primary |
Addresses
Primary practice location
808 N Franklin St
#2801
Tampa, FL 33602-3859
Mailing address
808 N Franklin St
2801
Tampa, FL 33602-3859
Phone (323) 868-6670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160229001306 | FL | Order and Referring Only - Other (Physician) | 7315242336 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN20550 | FL | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PSL Dental Management | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Port St Lucie, FL
- NPI 1245082247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1114112935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 N FRANKLIN ST",
"address_2": "2801",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023859",
"telephone_number": "323-868-6670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 N FRANKLIN ST",
"address_2": "#2801",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023859",
"telephone_number": "323-868-6670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANKIN",
"first_name": "MIKHAIL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-14",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN20550",
"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 Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.