Active NPI
Raymond Dustin Dixon, DMD
- Dentist
- University Park, FL
National Provider Identifier
1790088755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 19229
- Practice address
- 5231 University Pkwy Unit 120
University Park, FL 34201-3009 - Phone
- (941) 363-0458
- Fax
- (941) 351-5827
- NPI assigned
- Dec 14, 2010
- Last updated
- Dec 14, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN 19229 | FL | Primary |
Addresses
Primary practice location
5231 University Pkwy Unit 120
University Park, FL 34201-3009
Mailing address
PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160324001339 | FL | Order and Referring Only - Dentist | 9335446988 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 19229 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dixon Dental Concepts Inc | Dentist | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292284800000",
"number": "1790088755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3189",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132203189",
"telephone_number": "315-454-6000",
"fax_number": "866-803-4943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5231 UNIVERSITY PKWY UNIT 120",
"city": "UNIVERSITY PARK",
"state": "FL",
"postal_code": "342013009",
"telephone_number": "941-363-0458",
"fax_number": "941-351-5827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "RAYMOND",
"middle_name": "DUSTIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-14",
"last_updated": "2010-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 19229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in University Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.