Individual provider Active NPI

Alexandra Farah Griffin, DDS

  • General Practice Dentistry
  • Land O' Lakes, FL
National Provider Identifier
1962882100
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN21189 Issued in FL
Practice address
5420 Land O Lakes Blvd Ste 103
Land O Lakes, FL 34639-3401
Phone
(813) 601-1122
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN21189 FL Primary

Addresses

Primary practice location

5420 Land O Lakes Blvd Ste 103
Land O Lakes, FL 34639-3401

Mailing address

5420 Land O Lakes Blvd Ste 103
Land O Lakes, FL 34639-3401
Phone (813) 601-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180119001609 FL Order and Referring Only - DentistPractitioner - Dentist 2668731647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brian F. Bernier, D.D.S., PA PastSince Aug 4, 2024 Accepting new patients
Monticciolo Family and Sedation Dentistry, PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1962882100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 LAND O LAKES BLVD STE 103",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346393401",
            "telephone_number": "813-601-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 LAND O LAKES BLVD STE 103",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346393401",
            "telephone_number": "813-601-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "ALEXANDRA",
        "middle_name": "FARAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O' Lakes, FL

Sources for this page

Verify at the official NPI Registry.