Healthcare Provider Details

I. General information

NPI: 1962620120
Provider Name (Legal Business Name): JOSE A. ITURREGUI, D.D.S., M.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 E GRAVES AVE SUITE A
ORANGE CITY FL
32763-5263
US

IV. Provider business mailing address

177 E GRAVES AVE SUITE A
ORANGE CITY FL
32763-5263
US

V. Phone/Fax

Practice location:
  • Phone: 386-775-7000
  • Fax: 386-775-7019
Mailing address:
  • Phone: 386-775-7000
  • Fax: 386-775-7019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN0014097
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN0014097
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN0014097
License Number StateFL

VIII. Authorized Official

Name: DR. JOSE A. ITURREGUI
Title or Position: PRESIDENT
Credential: D.D.S., M.S.
Phone: 386-775-7000