Active NPI
Wagner Rodrigues Duarte, DDS
- Periodontics
- Gainesville, FL
National Provider Identifier
1407305022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 638
- Practice address
- 1600 SW Archer Rd
Room D10-6
Gainesville, FL 32610-0434 - Phone
- (352) 273-8360
- NPI assigned
- Sep 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 638 | FL | Primary |
Addresses
Primary practice location
1600 SW Archer Rd
Room D10-6
Gainesville, FL 32610-0434
Mailing address
1600 SW Archer Rd, Room D10-6 PO Box 100434
University of Florida, Department of Periodontology
Gainesville, FL 32610-0434
Phone (352) 273-8360
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
| License | State | Type | Specialty |
|---|---|---|---|
| 638 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1407305022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD, ROOM D10-6 PO BOX 100434",
"address_2": "UNIVERSITY OF FLORIDA, DEPARTMENT OF PERIODONTOLOGY",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100434",
"telephone_number": "352-273-8360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"address_2": "ROOM D10-6",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100434",
"telephone_number": "352-273-8360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "WAGNER",
"middle_name": "RODRIGUES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "638",
"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 Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.