Michael L Jarrell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN12007 Issued in FL

Practice address

1166 SW Main Blvd
Lake City, FL 32025-5780

Phone

(386) 752-7373

Fax

(386) 752-0056

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

Yes

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)

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.

• Coast Dental P.a.

  • Dentist
  • Lake City, FL
  • NPI 1760058093
  NPD (past)
• Coast Dental P.a.

  • Dentist
  • Tampa, FL
  • NPI 1992803860
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1912112541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 US 1 S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867278",
            "telephone_number": "904-494-8630",
            "fax_number": "904-494-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255780",
            "telephone_number": "386-752-7373",
            "fax_number": "386-752-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ta'Sheika Jackson
• Terries Jackson
• Susan Lorraine Jacobsen
• Rashad D James
• Stanley Janasiewicz
• Richard N Jaskiewicz, MD
• Jean-Felert Cadet MD, PA
• Marie Jean-Louis
• Jessica Jenkins
• Benjamin Bradley Jennings

• General Practice Dentistry in Lake City, FL
• Providers in Lake City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.