Active NPI
Velma J Dennis, DDS
- General Practice Dentistry
- Jacksonville, FL
National Provider Identifier
1730222654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5408-015
- Practice address
- 1536 N Jefferson St
Jacksonville, FL 32209-6525 - Phone
- (352) 674-5000
- NPI assigned
- Feb 14, 2007
- Last updated
- Dec 19, 2022
- Sex
- Female
- 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 | 5408-015 | WI | Primary |
Addresses
Primary practice location
1536 N Jefferson St
Jacksonville, FL 32209-6525
Mailing address
P.O. Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H3451 | Medicaid | NM |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5408-015 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1730222654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 130",
"city": "SAN FIDEL",
"state": "NM",
"postal_code": "870490130",
"telephone_number": "505-552-5300",
"fax_number": "505-552-5490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1536 N JEFFERSON ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322096525",
"telephone_number": "352-674-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "VELMA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5408-015",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H3451",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.