Active NPI
Justin Palmer, D.M.D.
- Dentist
- Hurlburt Field, FL
National Provider Identifier
1508270216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 20668
- Practice address
- 113 Lielmanis Ave
Hurlburt Field, FL 32544-5613 - Phone
- (850) 884-7881
- NPI assigned
- Jun 20, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 20668 | FL | Primary |
Addresses
Primary practice location
113 Lielmanis Ave
Hurlburt Field, FL 32544-5613
Mailing address
11035 Symington Cir
Louisville, KY 40241-1356
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 |
|---|---|---|---|
| 20668 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1508270216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11035 SYMINGTON CIR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402411356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 LIELMANIS AVE",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325445613",
"telephone_number": "850-884-7881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "JUSTIN",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-20",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "20668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurlburt Field, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.