Amelia Gentle Dentistry, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN10812 Issued in FL

Legal business name

AMELIA GENTLE DENTISTRY, LLC

Practice address

1699 S 14TH St Ste 21
Fernandina Beach, FL 32034-1965

Phone

(904) 277-8500

NPI assigned

Apr 15, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mark Robert Olbina, DDSNPI 1922121128

Title

President

Phone

(904) 277-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Robert Olbina, DDS

  • General Practice Dentistry
  • Fernandina Beach, FL
  • NPI 1922121128
  NPD Authorized official
• Jacquelyn Olbina Miller, D.M.D.

  • General Practice Dentistry
  • Fernandina Beach, FL
  • NPI 1679913610
  NPD
• Jessica Gindele Loumeau, DMD

  • General Practice Dentistry
  • Fernandina Beach, FL
  • NPI 1184874141
  NPD (past)

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1679969786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 21",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-277-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 21",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-277-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIA GENTLE DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "OLBINA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-277-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Chiropractic Clinic
• Amelia Dental Group, PLLC
• Amelia Express Care, LLC
• Amelia Express Care, LLC
• Amelia Eye Associates LLC
• Amelia Institute of Cardiology and Medicine
• Amelia Internal Medicine,P.a.
• Amelia Island Anesthesia LLC
• Amelia Island Doctors of Optometry
• Amelia Island Ekg Associates, PA

• All providers in Fernandina Beach, FL
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.