Fl Southern Dental PA
NPI 1265133185ActiveOrganization· Dentist, General Practice· St Augustine, FL
Dentist, General Practice in St Augustine, Florida, registered in NPPES in March 2023, part of Fl Southern Dental PA. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1265133185 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Fl Southern Dental PA |
| NPI issued | Mar 16, 2023 |
| Last updated in NPPES | Mar 17, 2026 |
| Certified by provider | Mar 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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 |
|---|
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