Active NPI
Trevor Dooley
- General Practice Dentistry
- Palmetto, FL
National Provider Identifier
1619709730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN29551
- Practice address
- 579 10TH St E
Palmetto, FL 34221-4013 - Phone
- (941) 315-9914
- NPI assigned
- Aug 16, 2024
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN29551 | FL | Primary |
Addresses
Primary practice location
579 10TH St E
Palmetto, FL 34221-4013
Mailing address
600 Technology Park Ste 101
Lake Mary, FL 32746-7122
Phone (407) 543-8514
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 |
|---|---|---|---|
| DN29551 | FL | MD | General 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": "1723766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1619709730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 TECHNOLOGY PARK STE 101",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327467122",
"telephone_number": "407-543-8514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "579 10TH ST E",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342214013",
"telephone_number": "941-315-9914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOOLEY",
"first_name": "TREVOR",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-16",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN29551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmetto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.