Individual provider Active NPI

Jillian Porto, DMD

  • General Practice Dentistry
  • Seminole, FL
National Provider Identifier
1548612377
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1580 Issued in FL
Practice address
9200 113TH St
Seminole, FL 33772-2800
Phone
(727) 394-6064
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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 1580 FL Primary

Addresses

Primary practice location

9200 113TH St
Seminole, FL 33772-2800

Mailing address

9200 113TH St
Seminole, FL 33772-2800
Phone (727) 394-6064

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
I20161117002416 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8527347376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1580FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1548612377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722800",
            "telephone_number": "727-394-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722800",
            "telephone_number": "727-394-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTO",
        "first_name": "JILLIAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "1580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.