Individual provider Active NPI

Austin Grovenstein, DMD

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1649953837
Registry record updated May 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN28055 Issued in FL
Practice address
9119 Merrill Rd Ste 29
Jacksonville, FL 32225-4306
Phone
(904) 549-9777
NPI assigned
Aug 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2025

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 DN28055 FL Primary

Addresses

Primary practice location

9119 Merrill Rd Ste 29
Jacksonville, FL 32225-4306

Mailing address

4530 St Johns Ave Ste 15
#225
Jacksonville, FL 32210-1852
Phone (904) 549-9777

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
I20230905002941 FL Practitioner - Dentist 2961865175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN28055FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Cove Family Dentistry, LLC CurrentSince Jun 3, 2025 Accepting new patients
Heart of Florida Health Center, Inc General Practice CurrentSince Aug 11, 2023 Accepting new patients
Heart of Florida Health Center, Inc General Practice CurrentSince Aug 11, 2023 Accepting new patients

Locations

9119 Merrill Rd
Ste 29
Jacksonville, FL 32225
Phone (904) 549-9777

4530 Saint Johns Ave
Ste 15
Jacksonville, FL 32210

6041 SW 54th St
Ste 100
Ocala, FL 34474
Phone (352) 854-0700

2553 E Silver Springs Blvd
Ocala, FL 34470
Phone (352) 867-0303

1025 SW 1st Ave
Ocala, FL 34471
Phone (352) 877-7140

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748131200000",
    "number": "1649953837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 ST JOHNS AVE STE 15",
            "address_2": "#225",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101852",
            "telephone_number": "904-549-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 MERRILL RD STE 29",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254306",
            "telephone_number": "904-549-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVENSTEIN",
        "first_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-05-25",
        "certification_date": "2025-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.