John Henry Penny, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6947 Issued in FL

Practice address

617 75TH Ave
St Pete Beach, FL 33706-1835

Phone

(727) 367-3313

Fax

(727) 367-9023

NPI assigned

Feb 23, 2007

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 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

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.

• Century Dental PLLC

  • Dental Clinic/Center
  • St Pete Beach, FL
  • NPI 1700421252
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437285707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 75TH AVE",
            "city": "ST PETE BEACH",
            "state": "FL",
            "postal_code": "337061835",
            "telephone_number": "727-367-3313",
            "fax_number": "727-367-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 75TH AVE",
            "city": "ST PETE BEACH",
            "state": "FL",
            "postal_code": "337061835",
            "telephone_number": "727-367-3313",
            "fax_number": "727-367-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNY",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "6947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mgroup Integrated Physician Services, LLC
• Mgroup Integrated Physician Services, PA
• Mgroup Physician Services of Florida, PLLC
• Dwayne Edward Pate, PHARMD
• John L Payne, P.T.
• Pinellas Regional Anesthesia Associates LLC
• Kristina R Potter-Martino, D.O.
• Audra Lina Radvil
• Michael I. Rauchway, M.D.
• Keith Roberts Runyan, M.D.

• General Practice Dentistry in St Pete Beach, FL
• Providers in St Pete Beach, FL by specialty
• General Practice Dentistry 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.