Individual provider Active NPI

John Gianatasio III, DMD

  • Dentist
  • Boynton Beach, FL
National Provider Identifier
1902296007
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9852 Issued in FL
Practice address
10075 S Jog Rd Ste 200
Boynton Beach, FL 33437-3536
Phone
(561) 733-8580
Fax
(561) 733-8844
NPI assigned
Jan 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9852 FL Primary

Addresses

Primary practice location

10075 S Jog Rd Ste 200
Boynton Beach, FL 33437-3536

Mailing address

10075 S Jog Rd Ste 200
Boynton Beach, FL 33437-3536
Phone (561) 733-8580

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9852FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1902296007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10075 S JOG RD STE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373536",
            "telephone_number": "561-733-8580",
            "fax_number": "561-733-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10075 S JOG RD STE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373536",
            "telephone_number": "561-733-8580",
            "fax_number": "561-733-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANATASIO",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "9852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.