ANNA MARIA ISLAND DENTAL INC. — NPI 1265729172 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in HOLMES BEACH, FL)

CMS-1500 Box 24J / 33a • NPI

1265729172

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1223G0001X (CMS C5)

Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)

Box 32 Service Location & ZIP+4

5319 GULF DR, HOLMES BEACH, FL, 34217-1742

✓ 9-Digit EDI 837 ZIP+4 (34217-1742)

Practice Phone & Referral Fax

(941) 778-1122

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1265729172 (ANNA MARIA ISLAND DENTAL INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1265729172` (NPI-2 Organization / Facility)
Provider / Legal Name	ANNA MARIA ISLAND DENTAL INC.
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `1223G0001X` (Dentist, General Practice)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	5319 GULF DR, HOLMES BEACH, FL, 34217-1742
Practice Telephone / Fax	Tel: (941) 778-1122
Administrative Mailing Address	16528 N DALE MABRY HWY, TAMPA, FL, 33618-1325
Enumeration & Last Sync	Enumerated: 2011-06-30 \| CMS Record Updated: 2011-06-30
Authorized Official	ANDREW MARTINEAU (DIRECTOR)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5319 GULF DR, HOLMES BEACH, FL, 34217-1742

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Plain-English Taxonomy & CMS Crosswalk (1223G0001X)

What Does Taxonomy Code 1223G0001X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223G0001X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code C5 (Dentist)
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ANNA MARIA ISLAND DENTAL INC.)

Typical CPT / Diagnostic Procedures:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1223G0001X` — Dentist, General Practice Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: FL \| License: `DN12356` \| Primary: Yes (Primary)

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ANNA MARIA ISLAND DENTAL INC. (NPI #1265729172)