Individual provider Active NPI

Gregory S Imhoff, DMD

  • Dentist
  • Tampa, FL
National Provider Identifier
1205160447
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN11907 Issued in FL
Practice address
11508 N 56TH St
Tampa, FL 33617-2239
Phone
(813) 989-2775
Fax
(813) 985-5980
NPI assigned
Sep 21, 2009
Last updated
Sep 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN11907 FL Primary

Addresses

Primary practice location

11508 N 56TH St
Tampa, FL 33617-2239

Mailing address

11508 N 56TH St
Tampa, FL 33617-2239
Phone (813) 989-2775

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
DN11907FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Artistic Smiles of Tampa Bay LLC Current Accepting new patients
Casanova & Imhoff DMD PA Past Accepting new patients

Organizations & group practices 2

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": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1205160447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11508 N 56TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336172239",
            "telephone_number": "813-989-2775",
            "fax_number": "813-985-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11508 N 56TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336172239",
            "telephone_number": "813-989-2775",
            "fax_number": "813-985-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMHOFF",
        "first_name": "GREGORY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.