Gasper Lazzara, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN4353 Issued in FL

Practice address

5000 Sawgrass Village Cir
Suite 3
Ponte Vedra Beach, FL 32082-5045

Phone

(904) 567-1400

Fax

(904) 273-6068

NPI assigned

Mar 31, 2008

Last updated

Mar 31, 2008By the provider in NPPES

Sex

Male

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1841462801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SAWGRASS VILLAGE CIR",
            "address_2": "SUITE 3",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825045",
            "telephone_number": "904-567-1400",
            "fax_number": "904-273-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SAWGRASS VILLAGE CIR",
            "address_2": "SUITE 3",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825045",
            "telephone_number": "904-567-1400",
            "fax_number": "904-273-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARA",
        "first_name": "GASPER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN4353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlene Kay Lamp, M.D.
• Mariah Lane, BCBA
• Meagan Amberle Laurens
• Laurnce Schulman (Laurence Schulmam LCSW)
• Bianca L Lawson, BCBA, M.ED
• Lindsey Leitman, APRN
• Desirae Lemmon, ARNP
• Alyssa Lenhardt, OTR/L
• Leonie King LLC (Ponte Vedra Premier Healthcare)
• Rose Ann Lickenbrock, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.