Individual provider Active NPI

Robert Elee Penrod, D.M.D.

  • General Practice Dentistry
  • Ocala, FL
National Provider Identifier
1609967462
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 16814 Issued in FL
Practice address
11206 SW 93Rd Court Rd Ste 200
Ocala, FL 34481-5252
Phone
(352) 390-2219
NPI assigned
Sep 27, 2006
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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 DN 16814 FL Primary

Addresses

Primary practice location

11206 SW 93Rd Court Rd Ste 200
Ocala, FL 34481-5252

Mailing address

5 Mulligan CT
Ocala, FL 34472-5010
Phone (352) 219-7494

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

LicenseStateTypeSpecialty
DN 16814FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1609967462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MULLIGAN CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344725010",
            "telephone_number": "352-219-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11206 SW 93RD COURT RD STE 200",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344815252",
            "telephone_number": "352-390-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "ROBERT",
        "middle_name": "ELEE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 16814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.