Healthcare Provider Details

I. General information

NPI: 1699577205
Provider Name (Legal Business Name): EMERALD DENIS KARIC DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 DOLPHIN DR
ST AUGUSTINE FL
32080-4531
US

IV. Provider business mailing address

281 CROSS RIDGE DR
PONTE VEDRA FL
32081-8445
US

V. Phone/Fax

Practice location:
  • Phone: 904-824-8652
  • Fax:
Mailing address:
  • Phone: 603-854-9747
  • Fax: 603-854-9747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number31158
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: