AMELIA RANDOLPH DMD, MS
NPI 1124459169
Dentist in Lake City, FL

Q: What is Amelia Randolph's NPI number?

The NPI number for Amelia Randolph is 1124459169. It was assigned to this individual provider in the NPPES registry on December 2, 2013.

Q: What is Amelia Randolph's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Amelia Randolph was last updated on December 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since December 02, 2013PECOS Enrolled

1779 SW BARNETT WAY, LAKE CITY, FL 32025(386) 755-4033 Get Directions Write a Review

NPPES record last updated: December 2, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Amelia Randolph Dmd, Ms NPPES

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

AMELIA RANDOLPH DMD, MS (NPI 1124459169) is an individual dentist in Lake City, Florida, licensed in Florida (FR3349669) and active in the NPI registry since December 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124459169

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameAMELIA RANDOLPHCredential: DMD, MS

Location Address1779 SW BARNETT WAYLake City, FL 32025-6957

Mailing Address1779 Sw Barnett WayLake City, FL 32025-6957

Phone(386) 755-4033

Sole ProprietorNo

Enumeration DateDecember 2, 2013

✔ NPI 1124459169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in FL · FR3349669

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1779 SW BARNETT WAY, Lake City, FL 32025

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amelia Randolph Dmd, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

KAREN KASSABIAN

Dentist (General Practice)

1779 SW BARNETT WAY
LAKE CITY, FL 32025

Columbia County (386) 755-4033

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 Amelia Randolph's NPI number?

The NPI number for Amelia Randolph is 1124459169. It was assigned to this individual provider in the NPPES registry on December 2, 2013.

Where is Amelia Randolph located?

Amelia Randolph practices at 1779 SW Barnett Way, Lake City, FL 32025. The listed phone number is (386) 755-4033.

What is Amelia Randolph's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Amelia Randolph enrolled in Medicare?

Yes. Amelia Randolph is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amelia Randolph was last updated on December 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.