Blue Water Dental of St. Johns
NPI 1821543513ActiveOrganization· Preferred Provider Organization· Ponte Vedra, FL
Preferred Provider Organization in Ponte Vedra, Florida, registered in NPPES in August 2016. The authorized official on file is David Wallace Sorensen, D.M.D., Dentist/Owner.
Overview
| NPI | 1821543513 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 23, 2016 |
| Last updated in NPPES | Aug 23, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | DN20719 | 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 |
|---|