Douglas G. Edwards, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN23254 Issued in FL

Practice address

4714 N Armenia Ave Ste 200
Tampa, FL 33603-2603

Phone

(813) 885-6555

Fax

(318) 262-2527

NPI assigned

Jan 30, 2017

Last updated

Sep 18, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Precident Florida PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Largo, FL
  • NPI 1154045599
  NPD (past)
• Precident Florida PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • St Petersburg, FL
  • NPI 1609464205
  NPD (past)

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1255878104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 37TH AVE N # 404",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337041416",
            "telephone_number": "516-987-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4714 N ARMENIA AVE STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032603",
            "telephone_number": "813-885-6555",
            "fax_number": "318-262-2527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10601 Seminole Blvd",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337783329",
            "country_code": "US",
            "telephone_number": "727-397-8503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DOUGLAS",
        "middle_name": "G.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-30",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN23254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Edwards III
• Alexis M Edwards, MS, LMHC
• Candace Edwards, IMH18911
• Charles Edwards, MD
• Denise K Edwards, MD
• Etheldra Renee Edwards
• Jesse Edwards
• Kristin Edwards, PHD
• Leetoria Edwards, ARNP
• Lenora Edwards

• Oral and Maxillofacial Surgery (Dentist) in Tampa, FL
• Providers in Tampa, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.