Active NPI
Krista B Parker, DMD
- General Practice Dentistry
- Panama City, FL
National Provider Identifier
1568813970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN 21936
- Practice address
- 2620 Jenks Ave
Panama City, FL 32405-4311 - Phone
- (850) 785-8586
- Fax
- (334) 281-1087
- NPI assigned
- Jun 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN 21936 | FL | Primary |
Addresses
Primary practice location
2620 Jenks Ave
Panama City, FL 32405-4311
Mailing address
2620 Jenks Ave
Panama City, FL 32405-4311
Phone (850) 785-8586
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DN 21936 | Other | FL | FLORIDA BOARD OF DENTAL EXAMINERS |
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 |
|---|---|---|---|
| DN 21936 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1568813970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2620 JENKS AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054311",
"telephone_number": "850-785-8586",
"fax_number": "334-281-1087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 JENKS AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054311",
"telephone_number": "850-785-8586",
"fax_number": "334-281-1087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "KRISTA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN 21936",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BOARD OF DENTAL EXAMINERS",
"identifier": "DN 21936",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.