Individual provider Active NPI

James Horan, D.M.D.

  • Periodontics
  • Stuart, FL
National Provider Identifier
1679793392
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN12252 Issued in FL
Practice address
900 SE Ocean Blvd
BLDG. a Ste. 102
Stuart, FL 34994-2471
Phone
(772) 781-0744
Fax
(772) 781-0748
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X DN12252 FL
Periodontics 1223P0300X DN12252 FL Primary

Addresses

Primary practice location

900 SE Ocean Blvd
BLDG. a Ste. 102
Stuart, FL 34994-2471

Mailing address

900 SE Ocean Blvd
BLDG. a Ste. 102
Stuart, FL 34994-2471

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
I20181031000381 FL Order and Referring Only - DentistPractitioner - Dentist 5092067967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN12252FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Periodontics, PA Periodontics Current Accepting new patients
Sleep Apnea Wellness Center LLC Durable Medical Equipment & Medical Supplies CurrentSince Feb 28, 2018 Accepting new patients

Locations

900 SE Ocean Blvd
Ste 102
Stuart, FL 34994
Phone (772) 781-0744

Organizations & group practices 2

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1679793392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SE OCEAN BLVD",
            "address_2": "BLDG. A STE. 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SE OCEAN BLVD",
            "address_2": "BLDG. A STE. 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942471",
            "telephone_number": "772-781-0744",
            "fax_number": "772-781-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORAN",
        "first_name": "JAMES",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "DN12252",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN12252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.