Active NPI
Justin Vice, D.M.D.
- Endodontics
- Tampa, FL
National Provider Identifier
1114302825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN25811
- Practice address
- 6526 Gunn Hwy
Tampa, FL 33625-4022 - Phone
- (813) 374-2290
- NPI assigned
- Jul 23, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Endodontics | 1223E0200X | DN25811 | FL | Primary |
Addresses
Primary practice location
6526 Gunn Hwy
Tampa, FL 33625-4022
Mailing address
6526 Gunn Hwy
Tampa, FL 33625-4022
Phone (616) 540-2584
Other practice location 1
14090 Big Crest Ln
Apt 406
Woodbridge, VA 22191-5530
Phone (616) 540-2584
Other practice location 2
150 55th St
Brooklyn, NY 11220
Phone (646) 801-0039
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN25811 | FL | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citrus Park Endodontics, PA | Past | 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.
-
- Dental Clinic/Center
- Tampa, FL
- NPI 1134230196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624147200000",
"number": "1114302825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6526 GUNN HWY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336254022",
"telephone_number": "616-540-2584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6526 GUNN HWY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336254022",
"telephone_number": "813-374-2290"
}
],
"practiceLocations": [
{
"address_1": "14090 Big Crest Ln",
"address_2": "Apt 406",
"address_purpose": "LOCATION",
"city": "Woodbridge",
"state": "VA",
"postal_code": "221915530",
"country_code": "US",
"telephone_number": "616-540-2584",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "150 55th St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "11220",
"country_code": "US",
"telephone_number": "646-801-0039",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VICE",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-23",
"last_updated": "2021-06-20",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN25811",
"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 Jun 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.