Individual provider Active NPI

Jessica Gindele Loumeau, DMD

  • General Practice Dentistry
  • Fernandina Beach, FL
National Provider Identifier
1184874141
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18503 Issued in FL
Practice address
1699 S 14TH St Ste 21
Fernandina Beach, FL 32034-1965
Phone
(904) 277-8500
NPI assigned
Sep 26, 2008
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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 DN18503 FL Primary

Addresses

Primary practice location

1699 S 14TH St Ste 21
Fernandina Beach, FL 32034-1965

Mailing address

1699 S 14TH St Ste 21
Fernandina Beach, FL 32034-1965
Phone (904) 277-8500

Other names 1

  • Dr. Jessica Gindele Former name

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
I20151020000305 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002125754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18503FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Amelia Gentle Dentistry, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1184874141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 21",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-277-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 21",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-277-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUMEAU",
        "first_name": "JESSICA",
        "middle_name": "GINDELE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GINDELE",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.