Individual provider Active NPI

Anny Oliva Perez, DMD

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1144602400
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN21257 Issued in FL
Practice address
7030 Normandy Blvd
Jacksonville, FL 32205-6206
Phone
(904) 786-5850
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN21257 FL Primary

Addresses

Primary practice location

7030 Normandy Blvd
Jacksonville, FL 32205-6206

Mailing address

12410 Whitmore Oaks Dr
Jacksonville, FL 32258-4229
Phone (786) 370-4563

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150910002101 FL Order and Referring Only - DentistPractitioner - Dentist 5193032993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Olimen Dental LLC CurrentSince Jul 12, 2020 Accepting new patients

Locations

2925 NE 199th St
Ste 309
Aventura, FL 33180
Phone (305) 935-4800

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1144602400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 WHITMORE OAKS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322584229",
            "telephone_number": "786-370-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 NORMANDY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056206",
            "telephone_number": "904-786-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA PEREZ",
        "first_name": "ANNY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.