Jennifer Boudreaux Georgiades, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN18019 Issued in FL

Practice address

910 Garden Gate Cir
Pensacola, FL 32504-8629

Phone

(850) 944-9655

Fax

(850) 941-1655

NPI assigned

Feb 14, 2008

Last updated

Jun 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1831367697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 GARDEN GATE CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048629",
            "telephone_number": "850-944-9655",
            "fax_number": "850-941-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 GARDEN GATE CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048629",
            "telephone_number": "850-944-9655",
            "fax_number": "850-941-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 W Michigan Ave",
            "address_2": "Suite 11",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325262222",
            "country_code": "US",
            "telephone_number": "850-944-9655",
            "fax_number": "850-941-1655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGIADES",
        "first_name": "JENNIFER",
        "middle_name": "BOUDREAUX",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George M Knefely MD PA
• Deidre Maria George-Mullins, M.S., LMFT
• Janice George, LMHC
• Maximilian James George, DO
• Scott Georges, PHARM D
• Gary E Gerhard, MD
• Geriatric Hospital Medicine
• Marcelo N Gerjoi, PA-C
• Katherine German, DDS
• Bryan Ian Gerstenberg, DDS

• Dentist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.