George Robert Vanetta, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0013529 Issued in FL

Practice address

1947 Citrona Dr
Fernandina Beach, FL 32034-4492

Phone

(904) 261-2980

NPI assigned

Aug 25, 2006

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

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• 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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1689782385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 A1A BEACH BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806733",
            "telephone_number": "904-261-2980"
        },
        {
            "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": "904-261-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANETTA",
        "first_name": "GEORGE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0013529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DN0013529",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Dominick Tribuzio, M.D.
• Vanessa Balthrop Tucker, M.S. CCC-SLP
• Heather Rae Tuerschmann, PT, DPT
• Diana R Twiggs, M.D.
• University of Florida Jacksonville Physicians, Inc
• Alison Marion Varhol, MS, RD, LD/N
• Vein Care Center of Amelia Island LLC
• Elizabeth A Verlinde, RDN
• Waas Drug Store Inc
• Wal-Mart Stores East LP

• 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 Feb 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.