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DERICK MAYBERRY DDS
NPI 1003369422
Dentist - Periodontics in Hurlburt Field, FL

Active since August 02, 2016
113 LIELMANIS AVE, HURLBURT FIELD, FL 32544(850) 881-2000 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Derick Mayberry Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERICK MAYBERRY DDS (NPI 1003369422) is an individual periodontics provider in Hurlburt Field, Florida, licensed in Vermont (016.0123575) and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1003369422
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDERICK MAYBERRYCredential: DDS
Location Address113 LIELMANIS AVEHurlburt Field, FL 32544-5613
Mailing Address4320 Commons Dr W Unit 5305Destin, FL 32541-8660 · (575) 956-5112
Phone(850) 881-2000
Sole ProprietorNo
Enumeration DateAugust 2, 2016
Last NPPES UpdateSeptember 1, 2020
NPPES CertifiedSeptember 1, 2020
✔ NPI 1003369422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in VT · 016.0123575
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
113 LIELMANIS AVE, Hurlburt Field, FL 32544
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSE ENCARNACION LUCIO
Technician, Other
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (850) 881-5855
DR. DON VONGVIPHUT DO
General Practice
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (850) 881-1020
DR. ROBERT KESEAD JR. O.D.
Optometrist
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (850) 883-3187
MS. DEBORAH K LANIUS MSN FNP
Nurse Practitioner (Family)
113 LIELMANIS AVE, 1 SOMDG
HURLBURT FIELD, FL 32544
Okaloosa County (850) 881-5221
WENDY S BORN CNP
Nurse Practitioner (Family)
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (850) 881-1257
BRITTON ADAMS IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (850) 884-1206
MRS. LISA MCFARLAND IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (850) 621-2865
ROSS GRAHAM M.D.
Emergency Medicine
113 LIELMANIS AVE
HURLBURT FIELD, FL 32544
Okaloosa County (808) 461-3307

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derick Mayberry's NPI number?

The NPI number for Derick Mayberry is 1003369422. It was assigned to this individual provider in the NPPES registry on August 2, 2016.

Where is Derick Mayberry located?

Derick Mayberry practices at 113 Lielmanis Ave, Hurlburt Field, FL 32544. The listed phone number is (850) 881-2000.

What is Derick Mayberry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Derick Mayberry was last updated on September 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.