Individual provider Active NPI

Eric Portalatin

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1194461574
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN27107 Issued in FL
Practice address
6 E Bay St Ste 101
Jacksonville, FL 32202-5416
Phone
(904) 356-0072
NPI assigned
May 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 DN27107 FL Primary

Addresses

Primary practice location

6 E Bay St Ste 101
Jacksonville, FL 32202-5416

Mailing address

8283 Baymeadows Rd E Apt 1218
Jacksonville, FL 32256-3058
Phone (904) 874-3534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220711003105 IA Order and Referring Only - DentistPractitioner - Dentist 6709266596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN27107FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, P.a. General Practice PastSince Feb 4, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1194461574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8283 BAYMEADOWS RD E APT 1218",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563058",
            "telephone_number": "904-874-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E BAY ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322025416",
            "telephone_number": "904-356-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTALATIN",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN27107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.