Individual provider Active NPI

Agerico M Sayoc

  • Prosthodontics
  • Jacksonville, FL
National Provider Identifier
1114365970
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN10831 Issued in FL
Practice address
13167 Atlantic Blvd
Jacksonville, FL 32225-3125
Phone
(904) 221-0054
Fax
(904) 221-0049
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DN10831 FL Primary

Addresses

Primary practice location

13167 Atlantic Blvd
Jacksonville, FL 32225-3125

Mailing address

13167 Atlantic Blvd
Jacksonville, FL 32225-3125
Phone (904) 221-0054

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
DN10831FLMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Agerico M Sayoc DMD MSD PA Prosthodontics 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.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1114365970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13167 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253125",
            "telephone_number": "904-221-0054",
            "fax_number": "904-221-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13167 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253125",
            "telephone_number": "904-221-0054",
            "fax_number": "904-221-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYOC",
        "first_name": "AGERICO",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN10831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; 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.