Active NPI
Carley Jeff Scott, D.M.D.
- General Practice Dentistry
- St Petersburg, FL
National Provider Identifier
1679692461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11693
- Practice address
- 239 2ND Ave S # 100
Saint Petersburg, FL 33701-4312 - Phone
- (727) 420-7944
- Fax
- (727) 898-8585
- NPI assigned
- Mar 29, 2007
- Last updated
- Dec 22, 2023
- 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 | 11693 | FL | Primary |
Addresses
Primary practice location
239 2ND Ave S # 100
Saint Petersburg, FL 33701-4312
Mailing address
239 2ND Ave S # 100
Saint Petersburg, FL 33701-4312
Phone (727) 420-7944
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 |
|---|---|---|---|
| 11693 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| International Center for Complete Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Customized Equipment (DME)
- St Petersburg, FL
- NPI 1154643377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1679692461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 2ND AVE S # 100",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337014312",
"telephone_number": "727-420-7944",
"fax_number": "727-898-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 2ND AVE S # 100",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337014312",
"telephone_number": "727-420-7944",
"fax_number": "727-898-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "CARLEY",
"middle_name": "JEFF",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "11693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.