MEDICARE: BOLD BITE ORTHODONTICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1023944592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOLD BITE ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	14035 BEACH BLVD STE 104
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-1507
Country	:	US
Telephone Number	:	904-595-6869
Fax Number	:

Provider Business Practice Location Address
First Line	:	14035 BEACH BLVD STE 104
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-1507
Country	:	US
Telephone Number	:	904-595-6869
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ORTHODONTIST
Name	:	MARTIN GREENBERG
Credential	:	DMD
Telephone Number	:	407-227-0721

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “BOLD BITE ORTHODONTICS PLLC ” Practice Location

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