Paul Bivens, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6295 Issued in FL

Practice address

4326 Park Blvd
Suite C-East
Pinellas Park, FL 33781-3555

Phone

(727) 544-5345

Fax

(727) 547-8263

NPI assigned

Aug 17, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 3, 2022 through Feb 3, 2028

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 and National Provider Directory roles.

• Dental Specialty Group of Tampa Bay PLLC

  • Dentist
  • Pinellas Park, FL
  • NPI 1720596067
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306950670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 HUNTINGTON PL",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346955233",
            "telephone_number": "727-726-9568",
            "fax_number": "727-547-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4326 PARK BLVD",
            "address_2": "SUITE C-EAST",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813555",
            "telephone_number": "727-544-5345",
            "fax_number": "727-547-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVENS",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "6295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bimini Manor
• Carly Rae Bines
• Bio-Medical Applications of Florida, Inc. (Fresenius Medical Care Pinellas Park)
• Carolyn Alexis Bird, MPAS
• Nicole Michelle Bishko, D. O.
• Alexandra Blair, RBT
• David Blakemore, PA-C
• Betty Blanco, DT
• Zoe Marie Blankenship
• David A Bloom, M.D., PH.D.

• Periodontics in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Periodontics 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.