Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1407101033 Individual Practitioner Female Practitioner

Dr. Irivelisse Stevens Porter , DMD

Dentist - General Practice • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Irivelisse Porter, DMD is a registered healthcare professional specializing in Dentist - General Practice in Jacksonville, FL. Practice services are available at 12086 FORT CAROLINE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12086 Fort Caroline Rd
Suite 105

Jacksonville, FL 322252687

Telephone 9048079127
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
363 Specialists

Practicing in Jacksonville, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL 19714

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1508110602

Doctor of Dental Medicine

Dr. Brooke Schloth Gilligan , DMD

Dentist - General Practice

NPI 1801516265

Doctor of Dental Medicine

NPI 1831751064

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 19, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location July 19, 2012

Registered at 12086 FORT CAROLINE RD, SUITE 105, JACKSONVILLE, FL 322252687 (Tel: 9048079127)

📍
Updated Business Mailing Address July 19, 2012

Registered at 5077 CREEK CROSSING DR, JACKSONVILLE, FL 322264779 (Tel: 9044634531)

👤
Provider Name / Credentials Updated July 19, 2012

Recorded as IRIVELISSE PORTER, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2012

Dentist (License #19714 in FL)

🟢
Initial NPI Registration & Enumeration July 19, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407101033
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2012
Last Update: July 19, 2012
Sole Proprietor: No

Mailing Address

5077 Creek Crossing Dr

Jacksonville, FL 322264779

Phone: 9044634531

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.