Individual provider Active NPI

David Kellogg, D.D.S., M.S.

  • Endodontics
  • Riverview, FL
National Provider Identifier
1255771267
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN 20366 Issued in FL
Practice address
10081 Beach Verbena Dr
Riverview, FL 33578-5491
Phone
(813) 741-1900
Fax
(813) 741-1901
NPI assigned
Jul 5, 2013
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN 20366 FL Primary

Addresses

Primary practice location

10081 Beach Verbena Dr
Riverview, FL 33578-5491

Mailing address

10081 Beach Verbena Dr
Riverview, FL 33578-5491
Phone (813) 741-1900

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
I20170321000439 FL Order and Referring Only - DentistPractitioner - Dentist 3072898782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN 20366FLMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Kellogg Endodontics, P.a. Endodontics CurrentSince Dec 7, 2025 Accepting new patients

Locations

10028 Water Works Ln
Riverview, FL 33578
Phone (813) 677-9525

10081 Beach Verbena Dr
Riverview, FL 33578
Phone (813) 741-1900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1255771267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10081 BEACH VERBENA DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785491",
            "telephone_number": "813-741-1900",
            "fax_number": "813-741-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10081 BEACH VERBENA DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785491",
            "telephone_number": "813-741-1900",
            "fax_number": "813-741-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "DAVID",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN 20366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.