Individual provider Active NPI

Christina Varvarikos Schimenti, D.M.D

  • Dentist
  • Palm Coast, FL
National Provider Identifier
1174886170
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 19758 Issued in FL
Practice address
4 Old Kings Rd N Ste a
Palm Coast, FL 32137-8226
Phone
(386) 445-1234
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 19758 FL Primary

Addresses

Primary practice location

4 Old Kings Rd N Ste a
Palm Coast, FL 32137-8226

Mailing address

4 Old Kings Rd N Ste a
Palm Coast, FL 32137-8226

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
I20150709003051 FL Order and Referring Only - DentistPractitioner - Dentist 6507178159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 19758FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1174886170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OLD KINGS RD N STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OLD KINGS RD N STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378226",
            "telephone_number": "386-445-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIMENTI",
        "first_name": "CHRISTINA",
        "middle_name": "VARVARIKOS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 19758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.