Individual provider Active NPI

Briggs Alan McGinnis Jr., DMD

  • General Practice Dentistry
  • Pace, FL
National Provider Identifier
1508055153
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18075 Issued in FL
Practice address
5463 Woodbine Rd
Pace, FL 32571
Phone
(850) 995-4811
Fax
(850) 995-3243
NPI assigned
Oct 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 DN18075 FL Primary

Addresses

Primary practice location

5463 Woodbine Rd
Pace, FL 32571

Mailing address

5463 Woodbine Rd
Pace, FL 32571
Phone (850) 995-4811

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
I20160711001913 FL Order and Referring Only - DentistPractitioner - Dentist 6204128317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18075FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1508055153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5463 WOODBINE RD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-995-4811",
            "fax_number": "850-995-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5463 WOODBINE RD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-995-4811",
            "fax_number": "850-995-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "BRIGGS",
        "middle_name": "ALAN",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.