Jonathan David Weiss, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21872 Issued in FL

Practice address

272 SW Bentley PL
Lake City, FL 32025-6972

Phone

(386) 752-3043

NPI assigned

Jun 7, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 12, 2022 through Oct 12, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ramkissoon Weiss Dental PLLC

  • General Practice Dentistry
  • Lake City, FL
  • NPI 1013657063
  NPD
• Andrews & Wheeler, DMD PA

  • Dentist
  • Lake City, FL
  • NPI 1316113442
  NPD (past)
• Johann Ramkissoon, PLLC

  • Dentist
  • Lake City, FL
  • NPI 1710497862

  General Practice

  NPD (past)
• Melanie Holden, DMD, PLLC

  • Dentist
  • Lake City, FL
  • NPI 1205187143
  NPD (past)

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1225487689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257050",
            "telephone_number": "386-752-2480",
            "fax_number": "386-755-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 SW BENTLEY PL",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256972",
            "telephone_number": "386-752-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Michelle Weatherspoon
• Celeste B Webb, CRNA
• Frederick Thomas Weber, MD
• Johnathan Noel Weber
• Marshall Dean Webster, D.C.
• Gail Wells, RPH
• Sherman J Wells, PTA
• Robert Lawrence Wendel Jr., LCSW
• Wendy Krzoska LLC
• Westfield Medical Center Inc

• General Practice Dentistry in Lake City, FL
• Providers in Lake City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.