Joshua Owen Bietenholz, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17599 Issued in FL

Practice address

1947 Citrona Dr
Fernandina Beach, FL 32034-4492

Phone

(904) 261-7181

NPI assigned

Aug 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 8, 2016 through Jul 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Amelia Dental Group, PLLC

  • Dentist
  • Fernandina Beach, FL
  • NPI 1649350349
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659489953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1947 CITRONA DRIVE",
            "city": "FERNADINA BEACH",
            "state": "FL",
            "postal_code": "32034",
            "telephone_number": "904-261-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 CITRONA DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344492",
            "telephone_number": "904-261-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIETENHOLZ",
        "first_name": "JOSHUA",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DN17599",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott R Bergquist
• Joshua R Beyl
• Beyond the Couch, LLC
• Kimberly H Bibb, APRN
• Ernest Paul Bicknell III, PSYD
• Bio-Medical Applications of Florida, Inc. (Fresenius Kidney Care Amelia Island Dialysis)
• Anna Rene' Morris Blackshear, LMHC
• Jeffrey W Blake, MD
• William Stephen Bledsoe, PHARMD
• April Faizonia Blue-Moseley

• General Practice Dentistry in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.