Active NPI
Steven R Serkin, D.D.S.
- General Practice Dentistry
- Ormond Beach, FL
National Provider Identifier
1902059660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6453
- Practice address
- 42 Bay Pointe Dr
Ormond Beach, FL 32174-9233 - Phone
- (407) 310-4843
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 6453 | FL | Primary |
Addresses
Primary practice location
42 Bay Pointe Dr
Ormond Beach, FL 32174-9233
Mailing address
42 Bay Pointe Drive
Ormond Beach, FL 32174
Phone (407) 310-4843
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 |
|---|---|---|---|
| 6453 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1902059660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 BAY POINTE DRIVE",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "32174",
"telephone_number": "407-310-4843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 BAY POINTE DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321749233",
"telephone_number": "407-310-4843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERKIN",
"first_name": "STEVEN",
"middle_name": "R",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "6453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.