Active NPI
Charles Leonard Gary Jr., DDS
- General Practice Dentistry
- St Petersburg, FL
National Provider Identifier
1811913817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D4773
- Practice address
- 6700 Crosswinds Drive
Suite 300C
St Petersburg, FL 33710-5482 - Phone
- (727) 341-2422
- Fax
- (727) 341-2720
- NPI assigned
- Jul 14, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D4773 | FL | Primary |
Addresses
Primary practice location
6700 Crosswinds Drive
Suite 300C
St Petersburg, FL 33710-5482
Mailing address
14186 West Parsley Drive
Madeira Beach, FL 33708
Phone (727) 397-2131
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D4773 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| De Lucia Family Dental, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Preferred Provider Organization
- St Petersburg, FL
- NPI 1932468675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811913817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14186 WEST PARSLEY DRIVE",
"city": "MADEIRA BEACH",
"state": "FL",
"postal_code": "33708",
"telephone_number": "727-397-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 CROSSWINDS DRIVE",
"address_2": "SUITE 300C",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337105482",
"telephone_number": "727-341-2422",
"fax_number": "727-341-2720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARY",
"first_name": "CHARLES",
"middle_name": "LEONARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "D4773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.