Individual provider Active NPI

John Kim Neubert, D.D.S., PH.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Gainesville, FL
National Provider Identifier
1760448989
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DTP394 Issued in FL
Practice address
1600 SW Archer Rd
D4-4
Gainesville, FL 32610-3003
Phone
(352) 273-5800
Fax
(352) 392-3070
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DTP394 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
D4-4
Gainesville, FL 32610-3003

Mailing address

PO Box 100405
Gainesville, FL 32610-0405
Phone (352) 273-5687

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
I20160311000368 FL Order and Referring Only - DentistPractitioner - Dentist 2961509591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760448989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100405",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100405",
            "telephone_number": "352-273-5687",
            "fax_number": "352-392-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "D4-4",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-5800",
            "fax_number": "352-392-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBERT",
        "first_name": "JOHN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DTP394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.