Brenda R Hamilton, DMD, MS, FAGD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN26688 Issued in FL

Practice address

14866 Old Saint Augustine Rd Ste 111
Jacksonville, FL 32258-2611

Phone

(904) 342-6222

NPI assigned

Jan 24, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Borinquen Periodontics & Dental Implants PLLC

  • Dental Clinic/Center
  • Jacksonville, FL
  • NPI 1477273589
  NPD Authorized official

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1891765731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SCOTLAND YARD BLVD",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322595914",
            "telephone_number": "904-305-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14866 OLD SAINT AUGUSTINE RD STE 111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582611",
            "telephone_number": "904-342-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "BRENDA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, FAGD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN26688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Hames
• Tewabech K Hamesso
• Blake Hamil
• Amah Olufumilayo Hamilton
• Becky Lashone Hamilton
• Desirea Hamilton, PHARM.D.
• Emily Hamilton
• Jakob Skyler Hamilton, MD
• Jared Hamilton, DC
• Katherine Hamilton, APRN

• Periodontics in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.