Active NPI
Douglas G. Genninger, D.D.S.
- Dentist
- Tampa, FL
National Provider Identifier
1235333469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9851
- Practice address
- 1305 W Fletcher Ave
Tampa, FL 33612-3310 - Phone
- (813) 968-4808
- Fax
- (813) 968-3439
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9851 | FL | Primary |
Addresses
Primary practice location
1305 W Fletcher Ave
Tampa, FL 33612-3310
Mailing address
19114 Avenue Bayonnes
Lutz, FL 33558-5358
Phone (813) 949-2234
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9851 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235333469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19114 AVENUE BAYONNES",
"city": "LUTZ",
"state": "FL",
"postal_code": "335585358",
"telephone_number": "813-949-2234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 W FLETCHER AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336123310",
"telephone_number": "813-968-4808",
"fax_number": "813-968-3439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENNINGER",
"first_name": "DOUGLAS",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "9851",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.