Unknown Individual – General Practice Dentistry, NPI 1104882562

Unknown Individual is a healthcare provider. based in Panama city, Florida. specializing in General Practice Dentistry. They hold a License No. DN8483 (FL). The NPI Number for Unknown Individual is 1104882562

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104882562
Phone
(850) 769-5443
Address
3518 E 15TH ST
Deactivation Date
14 August 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • East 15th Street, Panama City, Bay County, Florida, 32405, United States

    PANAMA CITY, FL 324045831

    Phone: (850) 769-5443

    Fax: (850) 769-0829

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32404)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1104882562 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with General Practice Dentistry. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Panama City, Florida for Unknown Individual; download NPPES for the complete set.
What if Panama City, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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