Active NPI
Steven J Underkofler, D.M.D.
- Dentist
- Jacksonville, FL
National Provider Identifier
1619910148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN0010658
- Practice address
- 1746 University Blvd S
Jacksonville, FL 32216-8929 - Phone
- (904) 724-3023
- NPI assigned
- Jun 13, 2006
- Last updated
- Jul 13, 2026
- 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 | DN0010658 | FL | Primary |
Addresses
Primary practice location
1746 University Blvd S
Jacksonville, FL 32216-8929
Mailing address
10753 Waverly Bluff Way
Jacksonville, FL 32223-6681
Phone (904) 262-1262
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171219003228 | FL | Order and Referring Only - Dentist | 5395003420 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0010658 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1619910148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10753 WAVERLY BLUFF WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322236681",
"telephone_number": "904-262-1262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1746 UNIVERSITY BLVD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168929",
"telephone_number": "904-724-3023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERKOFLER",
"first_name": "STEVEN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN0010658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.