Gary Royal Selby, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5777 Issued in FL

Practice address

410 W Bloomingdale Ave
Brandon, FL 33511-7402

Phone

(813) 654-0037

Fax

(813) 654-0227

NPI assigned

Jul 21, 2006

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Gary Selby DDS PA

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1053332379
  NPD (past) Authorized official
• Sage Dental of Brandon PLLC

  • Dentist
  • Brandon, FL
  • NPI 1417617689
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982625323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 LAUREL TREE WAY",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118030",
            "telephone_number": "813-654-0037",
            "fax_number": "813-654-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117402",
            "telephone_number": "813-654-0037",
            "fax_number": "813-654-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "GARY",
        "middle_name": "ROYAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "5777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Sedlack, FNP-C
• Gayatri Seenanan, NURSE PRACTITIONER
• Seggyyen Ventures LLC
• Seggyyen Ventures LLC
• Selahcare
• Self-Flourish, LLC
• Jameson Self, LMT
• Senior Living Properties IV, LLC
• Lauren Lynn Sentovich, LCSW
• Jerrica Serrano

• General Practice Dentistry in Brandon, FL
• Providers in Brandon, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.