Individual provider Active NPI

David Grant Parker, DDS

  • General Practice Dentistry
  • Brandon, FL
National Provider Identifier
1235255845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0011501 Issued in FL
Practice address
227 N Knights Ave
Brandon, FL 33510-4390
Phone
(813) 685-5611
Fax
(813) 689-5900
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN0011501 FL Primary

Addresses

Primary practice location

227 N Knights Ave
Brandon, FL 33510-4390

Mailing address

227 N Knights Ave
Brandon, FL 33510-4390
Phone (813) 685-5611

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
I20150708002658 FL Order and Referring Only - DentistPractitioner - Dentist 9739491473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0011501FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Family Dental Care LLC General Practice PastSince Oct 27, 2019 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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235255845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 N KNIGHTS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104390",
            "telephone_number": "813-685-5611",
            "fax_number": "813-689-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N KNIGHTS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104390",
            "telephone_number": "813-685-5611",
            "fax_number": "813-689-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "DAVID",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0011501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.