DR. IRIVELISSE STEVENS PORTER (NPI# 1407101033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407101033 |
| Entity Type | Individual |
| Full Name | DR. IRIVELISSE STEVENS PORTER |
| Credential | DMD |
| Practice Address |
12086 Fort Caroline Rd Suite 105 Jacksonville FL 32225-2687 |
| Mailing Address |
5077 Creek Crossing Dr Jacksonville FL 32226-4779 |
| Practice Telephone | 9048079127 |
| Mailing Telephone | 9044634531 |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
19714 | FL | Dental Providers |
| Street Address |
12086 FORT CAROLINE RD SUITE 105 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32225-2687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184602583 | Kia Michon Mitchell | Family Medicine | 12086 Fort Caroline Rd, Ste 401, Jacksonville, FL 32225-2687 | 2006-01-05 |
| 1104378777 | Stephanie Megumi Lamm | Physician Assistant | 12086 Fort Caroline Rd, 401, Jacksonville, FL 32225-2687 | 2016-10-31 |
| 1730584673 | Megan Finck | Physician Assistant | 12086 Fort Caroline Rd, Suite #401, Jacksonville, FL 32225-2687 | 2014-11-04 |
| 1508110602 | Paul Schloth | Dentist | 12086 Fort Caroline Rd, Suite 105, Jacksonville, FL 32225-2687 | 2012-10-29 |
| 1356693881 | William Dewey Lee IIi | Physician Assistant | 12086 Fort Caroline Rd, Ste # 401, Jacksonville, FL 32225-2687 | 2012-10-08 |
| 1962704866 | Ft Caroline Chiropractic Clinic | Chiropractor | 12086 Fort Caroline Rd, Suite 302, Jacksonville, FL 32225-2687 | 2010-11-29 |
| 1518275254 | Kaitlin Ray | Nurse Practitioner | 12086 Fort Caroline Rd, 401, Jacksonville, FL 32225-2687 | 2010-09-15 |
| 1467778761 | Blake Moser | Chiropractor | 12086 Fort Caroline Rd, Suite 302, Jacksonville, FL 32225-2687 | 2010-04-12 |
| 1710162433 | Atlas Chiropractic Clinic Inc | Clinic/Center | 12086 Fort Caroline Rd, Unit 504, Jacksonville, FL 32225-2687 | 2007-12-31 |
| 1225212319 | Garth Clive Trinder-smith | Chiropractor | 12086 Fort Caroline Rd, Unit 504, Jacksonville, FL 32225-2687 | 2007-12-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700356367 | Ajay S Lewis | Counselor | 3010 Cobblewood Ln East, Jacksonville, FL 32225 | 2018-11-27 |
| 1467921569 | Heart To Heart LLC | Assisted Living Facility | 9378 Arlignton Expressway, Ste 218, Jacksonville, FL 32225 | 2018-11-19 |
| 1285122036 | National Vision, Inc. | Technician/Technologist | 11770 Atlantic Boulevard, Suite 300, Jacksonville, FL 32225 | 2018-04-27 |
| 1346757432 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 9422 Arlington Expressway, Jacksonville, FL 32225 | 2018-01-10 |
| 1831629690 | Family First Vision Care, Pllc | Optometrist | 9398 Arlington Expresway, Suite 1, Jacksonville, FL 32225 | 2017-06-14 |
| 1437689205 | West Point Optical Group | Optometrist | 9398-1 Arlington Expresway, Jacksonville, FL 32225 | 2017-06-14 |
| 1477087815 | Naila Ortega | Dentist | 984 Chapeltown Circle N, Jacksonville, FL 32225 | 2017-04-12 |
| 1487186342 | Sidnetta Rosemond | Durable Medical Equipment & Medical Supplies | 9501 Arlington Expy Ste160, Jacksonville, FL 32225 | 2017-03-30 |
| 1669925913 | Frances Mcmiller | Counselor | 9550 Regency Square Blvd Ste 706, Jacksonville, FL 32225 | 2016-08-03 |
| 1891143103 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 1211 St. Johns Bluff Rd North, Jacksonville, FL 32225 | 2016-05-26 |
| Find all providers in zip 32225 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962018424 | Sydney Fowler | Dentist | 12276 San Jose Blvd Ste 314, Jacksonville, FL 32223-8632 | 2020-09-21 |
| 1871106260 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 4445 Town Center Pkwy, Jacksonville, FL 32246-8565 | 2020-08-26 |
| 1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1659923118 | San Jose Aspen Pllc | Dentist | 10502 San Jose Blvd Ste B, Jacksonville, FL 32257-6209 | 2019-07-15 |
| 1326603176 | Evens Family Dental | Dentist | 13107 Atlantic Blvd, Jacksonville, FL 32225-7127 | 2019-05-07 |
| 1487123006 | Susan Prater Kudlats, D.m.d, P.a. | Dentist | 12620 Beach Blvd Ste 18, Jacksonville, FL 32246-7130 | 2018-11-14 |
| 1043792534 | Atlantic Dentistry Pa | Dentist | 13474 Atlantic Blvd Ste 109, Jacksonville, FL 32225-0100 | 2018-08-31 |
| 1447738620 | Argyle Dental Pllc | Dentist | 6001 Argyle Forest Blvd Ste 4, Jacksonville, FL 32244-6127 | 2018-07-31 |
| 1427534445 | Sandeep Chunduru | Dentist | 571 Yopp Rd Ste 308, Jacksonville, NC 28540-3683 | 2018-07-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32225 |
Please comment or provide details below to improve the information on DR. IRIVELISSE STEVENS PORTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.