Unknown Individual – Prosthodontics, NPI 1912111709

Unknown Individual is a healthcare provider. based in Daytona beach, Florida. specializing in Prosthodontics. They hold a License No. 10669 (FL). The NPI Number for Unknown Individual is 1912111709

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1912111709
Phone
(386) 239-7600
Address
1509 MASON AVE
Deactivation Date
17 July 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1509, Mason Avenue, Daytona Beach, Volusia County, Florida, 32114, United States

    DAYTONA BEACH, FL 321174548

    Phone: (386) 239-7600

    Fax: (386) 239-7088

    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 32117)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1912111709.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Prosthodontics for Unknown Individual. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Daytona Beach, Florida?
If you are local to Daytona Beach, Florida, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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