Bianca Elisa Gardner, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

31296 Issued in FL

Practice address

4579 E Highway 20 Ste 210
Niceville, FL 32578-9810

Phone

(850) 897-4200

NPI assigned

Aug 12, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mid Bay Dental PLLC

  dba Mid Bay Dental

  • General Practice Dentistry
  • Niceville, FL
  • NPI 1528427739
  NPD (past)
• Midbay Dental PPLC

  dba Mid Bay Dental

  • Dentist
  • Niceville, FL
  • NPI 1013376219
  NPD (past)

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1881205904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 E HIGHWAY 20 STE 210",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789810",
            "telephone_number": "850-897-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 E HIGHWAY 20 STE 210",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789810",
            "telephone_number": "850-897-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BIANCA",
        "middle_name": "ELISA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "31296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10470",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Nicole Frazier, NP
• Aleecia Lynn Furlong
• Leah Thompson Gagnon, D.M.D.
• Jose Leon Garcia-Rios, M.D.
• Jacob C Garcia, LCSW
• Michael Gargas, PHARMD
• Garry G Banks MD PA
• Stephany Eloisa Gaubeca Deveault, RBT
• Alyssa Marie Gavulic Howk, PHD, LMHC-S, LMFT-S
• Teresa Gee

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.