David Charles Jurocko, D.M.D., P.A.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 11623 Issued in FL

Practice address

13301 N Dale Mabry Hwy Ste B
Tampa, FL 33618-2400

Phone

(813) 961-4045

Fax

(813) 962-6972

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245446053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14243 PELHAM LN",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335563828",
            "telephone_number": "813-495-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 N DALE MABRY HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182400",
            "telephone_number": "813-961-4045",
            "fax_number": "813-962-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUROCKO",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 11623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "69458",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "882322",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tampa, FL
• Providers in Tampa, 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 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.

Verify at the official NPI Registry.