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NPI 1215667092ActiveIndividual· Dentist, General Practice· Gainesville, FL
Opted out of Medicare from April 2024 to April 2028. Dentist, General Practice in Gainesville, Florida, licensed in FL, with an NPI issued in June 2022. Part D covered 32 prescriptions written in 2024, 94% of them generic.
Overview
| NPI | 1215667092 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jun 14, 2022 |
| Last updated in NPPES | Jun 14, 2022 |
| Certified by provider | Jun 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 26932 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Apr 2, 2024 – Apr 2, 2028 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
Part D prescriptions in 2024
| Prescriptions (claims) | 32 · 33 30-day fills |
|---|---|
| Patients | 22 |
| Total drug cost | $237.38 |
| Generic share | 94% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 123 general dentists in Gainesville · All general dentists in Florida