Individual provider Active NPI

Michael J Fernandez, D.M.D., P.A.

  • Dentist
  • Seminole, FL
National Provider Identifier
1992896690
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN14109 Issued in FL
Practice address
9009 Park Blvd
Seminole, FL 33777-4152
Phone
(727) 397-6673
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN14109 FL Primary

Addresses

Primary practice location

9009 Park Blvd
Seminole, FL 33777-4152

Mailing address

7895 Seminole Blvd Ste 202
Seminole, FL 33772-4891
Phone (727) 397-6673

Other practice location 1

14100 58th St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

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
I20251028001715 FL Practitioner - Dentist 8820587132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Florida College of Dentistry, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14100 58TH St N
Clearwater, FL 33760-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
DN14109FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Pinellas Inc. CurrentSince Oct 17, 2025 Accepting new patients
Community Health Center of Pinellas Inc Current Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince Oct 17, 2025 Accepting new patients
Seminole Family Dental Care PLLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

14100 58th St N
Clearwater, FL 33760

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

7895 Seminole Blvd
Ste 202
Seminole, FL 33772
Phone (727) 397-6673

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1992896690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7895 SEMINOLE BLVD STE 202",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724891",
            "telephone_number": "727-397-6673",
            "fax_number": "727-393-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774152",
            "telephone_number": "727-397-6673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14100 58th St N",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337609900",
            "country_code": "US",
            "telephone_number": "727-824-8181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.