Individual provider Active NPI

Gaurang Nanavati, D.D.S

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1497880314
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15456 Issued in FL
Practice address
16021 Tampa Palms Blvd W
Tampa, FL 33647-2001
Phone
(813) 866-1100
Fax
(813) 558-8931
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15456 FL Primary

Addresses

Primary practice location

16021 Tampa Palms Blvd W
Tampa, FL 33647-2001

Mailing address

16021 Tampa Palms Blvd W
Tampa, FL 33647-2001
Phone (813) 866-1100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170216001271 FL Order and Referring Only - DentistPractitioner - Dentist 4789967704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15456FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497880314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16021 TAMPA PALMS BLVD W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472001",
            "telephone_number": "813-866-1100",
            "fax_number": "813-558-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16021 TAMPA PALMS BLVD W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472001",
            "telephone_number": "813-866-1100",
            "fax_number": "813-558-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANAVATI",
        "first_name": "GAURANG",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "15456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.