Individual provider Active NPI

Sam J Guarnieri, DMD

  • General Practice Dentistry
  • Leesburg, FL
National Provider Identifier
1851418214
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16969 Issued in FL
Practice address
949 N 14TH St
Leesburg, FL 34748-3838
Phone
(352) 460-0164
Fax
(352) 460-0659
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN16969 FL Primary

Addresses

Primary practice location

949 N 14TH St
Leesburg, FL 34748-3838

Mailing address

11872 Via Lucerna Cir
Windermere, FL 34786-6079

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
I20150528002322 FL Order and Referring Only - DentistPractitioner - Dentist 1759601966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1851418214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11872 VIA LUCERNA CIR",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 N 14TH ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483838",
            "telephone_number": "352-460-0164",
            "fax_number": "352-460-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARNIERI",
        "first_name": "SAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.