Individual provider Active NPI

Brian Garcia, DMD

  • Dentist
  • Marco Island, FL
National Provider Identifier
1639661432
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN27457 Issued in FL
Practice address
606 Bald Eagle Dr Ste 200
Marco Island, FL 34145-2731
Phone
(239) 394-1004
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 091031685 IL
Dentist 122300000X DN27457 FL Primary

Addresses

Primary practice location

606 Bald Eagle Dr Ste 200
Marco Island, FL 34145-2731

Mailing address

606 Bald Eagle Dr Ste 200
Marco Island, FL 34145-2731
Phone (239) 394-1004

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
I20230713001314 FL Practitioner - Dentist 3678933314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
091031685ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1639661432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 BALD EAGLE DR STE 200",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452731",
            "telephone_number": "239-394-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BALD EAGLE DR STE 200",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452731",
            "telephone_number": "239-394-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "091031685",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marco Island, FL

Sources for this page

Verify at the official NPI Registry.