Individual provider Active NPI

Robert Gherman, DMD

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1487330916
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28288 Issued in FL
Practice address
11645 Beach Blvd Ste 110
Jacksonville, FL 32246-8482
Phone
(904) 901-9411
NPI assigned
Jun 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28288 FL Primary

Addresses

Primary practice location

11645 Beach Blvd Ste 110
Jacksonville, FL 32246-8482

Mailing address

12750 Josslyn LN
Jacksonville, FL 32246-2292
Phone (702) 927-7278

Other practice location 1

7602 W Sand Lake Rd
Orlando, FL 32819-5112
Phone (407) 901-2218

Other practice location 2

8701 Maitland Summit Blvd
Orlando, FL 32810-5915
Phone (407) 974-5160

Other practice location 3

1081 A1A Beach Blvd
St Augustine, FL 32080-6733
Phone (904) 471-3291

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
28288FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Dental P.a. Dentist CurrentSince Jul 1, 2024 Accepting new patients
Coast Dental P.a. Dentist PastSince Jul 1, 2024 Accepting new patients

Locations

1081 A1A Beach Blvd
Saint Augustine, FL 32080
Phone (904) 417-3291

Organizations & group practices 2

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1487330916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12750 JOSSLYN LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322462292",
            "telephone_number": "702-927-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BEACH BLVD STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468482",
            "telephone_number": "904-901-9411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7602 W Sand Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328195112",
            "country_code": "US",
            "telephone_number": "407-901-2218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Maitland Summit Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328105915",
            "country_code": "US",
            "telephone_number": "407-974-5160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1081 A1A Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320806733",
            "country_code": "US",
            "telephone_number": "904-471-3291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHERMAN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "28288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.