MRS. KIMBERLEY BROOKE MOWERY DMD
NPI 1063716678
Dentist - General Practice in Gainesville, FL

Active since December 23, 2010
4960 NEWBERRY ROAD, SUITE 220, GAINESVILLE, FL 32607(352) 332-6725(352) 332-6725 Get Directions Write a Review

NPPES record last updated: December 23, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mrs. Kimberley Brooke Mowery Dmd NPPES

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

MRS. KIMBERLEY BROOKE MOWERY DMD (NPI 1063716678) is an individual general practice provider in Gainesville, Florida, licensed in Florida (DN15902) and active in the NPI registry since December 2010.

NPPES Registry Identity

NPI1063716678
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameMRS. KIMBERLEY BROOKE MOWERYCredential: DMD
Location Address4960 NEWBERRY ROAD, SUITE 220Gainesville, FL 32607
Mailing Address4960 Newberry Road, Suite 220Gainesville, FL 32607 · (352) 332-6725 · Fax (352) 372-1717
Fax(352) 332-6725
Sole ProprietorNo
Enumeration DateDecember 23, 2010
NPI 1063716678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in FL · DN15902
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4960 NEWBERRY ROAD, Gainesville, FL 32607

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Mrs. Kimberley Brooke Mowery Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 18, 2024 through February 18, 2026.

Opt-Out Effective DateFebruary 18, 2024
Opt-Out In Effect ThroughFebruary 18, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063716678, enumerated as an "individual" on December 23, 2010.

The provider is located at 4960 NEWBERRY ROAD SUITE 220 GAINESVILLE, FL 32607 and the phone number is (352) 332-6725.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.