Individual provider Active NPI

Vibhuti Garg, DMD

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1134840382
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN27511 Issued in FL
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

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DN27511FLMDDentist

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.

Verify at the official NPI Registry.