Active NPI
Jacinta Gaitor
- General Practice Dentistry
- Avon Park, FL
National Provider Identifier
1871785469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN18140
- Practice address
- 950 County Road 17a W
Avon Park, FL 33825-2164 - Phone
- (863) 452-3000
- Fax
- (863) 452-3069
- NPI assigned
- Aug 16, 2007
- Sex
- Female
- 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 | DN18140 | FL | Primary |
Addresses
Primary practice location
950 County Road 17a W
Avon Park, FL 33825-2164
Mailing address
950 County Road 17a W
Avon Park, FL 33825-2164
Phone (863) 452-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003063500 | Medicaid | FL | |
| DN18140 | Other | FL | STATE LICENSE |
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 |
|---|---|---|---|
| DN18140 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1871785469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 COUNTY ROAD 17A W",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338252164",
"telephone_number": "863-452-3000",
"fax_number": "863-452-3069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 COUNTY ROAD 17A W",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338252164",
"telephone_number": "863-452-3000",
"fax_number": "863-452-3069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAITOR",
"first_name": "JACINTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-16",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN18140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003063500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "DN18140",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.