Active NPI
Vibhuti Garg, DMD
- General Practice Dentistry
- Jacksonville, FL
National Provider Identifier
1134840382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN27511
- Practice address
- 5149 Normandy Blvd Unit 4
Jacksonville, FL 32205-4861 - Phone
- (904) 781-1201
- NPI assigned
- Sep 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN27511 | FL | |
| General Practice Dentistry | 1223G0001X | DN27511 | FL | Primary |
Addresses
Primary practice location
5149 Normandy Blvd Unit 4
Jacksonville, FL 32205-4861
Mailing address
6109 Dunn Ave
San Jose, CA 95123-4826
Phone (612) 447-9053
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 |
|---|---|---|---|
| DN27511 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1134840382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6109 DUNN AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951234826",
"telephone_number": "612-447-9053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5149 NORMANDY BLVD UNIT 4",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322054861",
"telephone_number": "904-781-1201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARG",
"first_name": "VIBHUTI",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-07",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN27511",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN27511",
"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 Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.