Active NPI
Geraldine Mackoul Ferris, DMD
- Periodontics
- Jacksonville, FL
National Provider Identifier
1235634205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN8385
- Practice address
- 2280 Shepard St Apt 505
Jacksonville, FL 32211-3284 - Phone
- (407) 497-0298
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN8385 | FL | Primary |
Addresses
Primary practice location
2280 Shepard St Apt 505
Jacksonville, FL 32211-3284
Mailing address
2280 Shepard St Apt 505
Jacksonville, FL 32211-3284
Phone (407) 497-0298
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 |
|---|---|---|---|
| DN8385 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1235634205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2280 SHEPARD ST APT 505",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322113284",
"telephone_number": "407-497-0298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2280 SHEPARD ST APT 505",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322113284",
"telephone_number": "407-497-0298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERRIS",
"first_name": "GERALDINE",
"middle_name": "MACKOUL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-29",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN8385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.