DR. GUSTAVO J WISCOVITCH (NPI# 1831212331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831212331 |
| Entity Type | Individual |
| Full Name | DR. GUSTAVO J WISCOVITCH |
| Credential | DMD |
| Practice Address |
6031 Dr Martin Luther King Jr St N St Petersburg FL 33703-1139 |
| Practice Telephone | 7275216645 |
| Practice Fax Number | 7275216648 |
| Mailing Telephone | 7275216645 |
| Mailing Fax Number | 7275216648 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
0014499 | FL | Dental Providers |
| Street Address |
6031 DR MARTIN LUTHER KING JR ST N |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33703-1139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336262880 | David D Whitaker | Dentist | 6031 Dr Martin Luther King Jr St N, St Petersburg, FL 33703-1139 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376150276 | Stephanie Gayle Barnes | Rehabilitation Practitioner | 610 47th Ave N, St Petersburg, FL 33703 | 2020-09-25 |
| 1366945099 | St. Petersburg Free Clinic | General Practice | 5501 - 4th Street North, St. Petersburg, FL 33703 | 2018-03-08 |
| 1306381363 | Dominique Timothee | Behavioral Analyst | 4301 16th Street N, St Petersburg, FL 33703 | 2016-12-30 |
| 1962849455 | Bobbie Vaughn | Behavioral Analyst | 880 6th St. South, St. Petersburg, FL 33703 | 2013-05-24 |
| 1255672796 | Mary Paige Bourbeau | Nurse Practitioner | 5500 9th St N., St Petersburg, FL 33703 | 2013-03-07 |
| 1437435237 | Lynn Bonner-nelson | Counselor | 6161 Dr. Mlk Jr Street N. #204, Saint Petersburg, FL 33703 | 2011-10-25 |
| 1245545953 | Patricia Reynolds | Speech-Language Pathologist | 3950 3rd Street North, Suite D, Community Rehab Associates, St. Petersburg, Fl, FL 33703 | 2010-08-18 |
| 1326367145 | Sigurd T Rutkis | Occupational Therapist | 3835 1st Street Northeast, St. Petersburg, FL 33703 | 2010-05-18 |
| 1922338136 | Christy Carr | Mechanotherapist | 5560 Kelly Dr N, Saint Petersburg, FL 33703 | 2010-01-11 |
| 1871730317 | Ronald H Copenhaver Dmd Pa | Dentist | 4338 1st Street N, Suite C, St. Petersburg, FL 33703 | 2009-01-20 |
| Find all providers in zip 33703 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609039585 | Nicholas Joseph Williams IIi | Dentist | 2201 49th St N, St Petersburg, FL 33710-3508 | 2008-07-09 |
| 1336262880 | David D Whitaker | Dentist | 6031 Dr Martin Luther King Jr St N, St Petersburg, FL 33703-1139 | 2007-04-09 |
| 1487790770 | Margaret Helen Young | Dentist | 509 Pasadena Avenue South, St Petersburg, FL 33707 | 2007-01-30 |
| 1922199512 | Craig C Broome | Dentist | 2201 49th Street N, St Petersburg, FL 33710-3508 | 2006-09-27 |
| 1811033111 | Professional Endodontics of Pinellas County Pa | Dentist | 509 Pasadena Avenue South, St Petersburg, FL 33707 | 2007-01-30 |
| 1831280429 | D Craig Duerson | Dentist | 2201 49th Street N, St Petersburg, FL 33710-3508 | 2006-09-27 |
| 1568553154 | Ron H Miller | Dentist | 2201 49th Street N, St Petersburg, FL 33710-3508 | 2006-09-27 |
| 1811918667 | Randall Thomas Hedrick | Dentist | 4957 38th Ave N, St Petersburg, FL 33710-2174 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608736 | Mid-florida Endodontics - Winter Garden Pa | Dentist | 15815 Shaddock Drive, Unit-3, Winter Garden, FL 34787 | 2020-10-30 |
| 1154935799 | Orbit Dental Management Pa | Dentist | 1453 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-1968 | 2020-09-01 |
| 1790397370 | Bruce D. Schulman, Dds Pa | Dentist | 10150 Hagen Ranch Rd Ste 200, Boynton Beach, FL 33437-3776 | 2020-08-17 |
| 1770117525 | Volusia Endodontics Pa | Dentist | 2751 Enterprise Rd Ste 211, Orange City, FL 32763-8262 | 2020-03-02 |
| 1417587130 | Advanced Endodontics of Winter Park, Pa | Dentist | 400 W Morse Blvd Ste 102, Winter Park, FL 32789-4259 | 2020-01-22 |
| 1699326603 | North Central Florida Endodontics,pllc | Dentist | 48 Se 16th Ave, Ocala, FL 34471-2521 | 2019-09-23 |
| 1396395919 | Stephen L. Goldfaden, Dds,pa | Dentist | 1905 Nw 13th St Ste 2, Gainesville, FL 32609-3414 | 2019-09-16 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1437707197 | John Zachary Reynolds | Dentist | 3180 Redeemer Way, New Port Richey, FL 34655-4245 | 2019-08-27 |
| 1497307987 | Bradley Sleeth | Dentist | 942 Goldridge Ct, Orange Park, FL 32065-6259 | 2019-07-15 |
| Find all providers with the same taxonomy | ||||
| City | ST PETERSBURG |
| Zip Code | 33703 |
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| 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.