Healthcare Provider Details
I. General information
NPI: 1962343491
Provider Name (Legal Business Name): JINCY DANIEL DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10720 STATE ROAD 54 STE 101
TRINITY FL
34655-2264
US
IV. Provider business mailing address
10720 STATE ROAD 54 STE 101
TRINITY FL
34655-2264
US
V. Phone/Fax
- Phone: 727-372-9955
- Fax: 727-372-7273
- Phone: 727-372-9955
- Fax: 727-372-7273
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JINCY
DANIEL
Title or Position: PRESIDENT
Credential: DMD
Phone: 727-372-9955