Individual provider Active NPI

Menachem Mendel Ivry

  • Oral and Maxillofacial Surgery (Dentist)
  • Gainesville, FL
National Provider Identifier
1265236749
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DRPM3075 Issued in FL
Practice address
1600 SW Archer Rd # D7-6
Gainesville, FL 32610-0416
Phone
(352) 273-6750
Fax
(352) 392-7609
NPI assigned
Apr 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DRPM3075 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd # D7-6
Gainesville, FL 32610-0416

Mailing address

1600 SW Archer Rd # D7-6
Gainesville, FL 32610-0416
Phone (352) 273-6750

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

LicenseStateTypeSpecialty
14196CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Frida Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1265236749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD # D7-6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100416",
            "telephone_number": "352-273-6750",
            "fax_number": "352-392-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD # D7-6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100416",
            "telephone_number": "352-273-6750",
            "fax_number": "352-392-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVRY",
        "first_name": "MENACHEM",
        "middle_name": "MENDEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-03",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DRPM3075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.