OrganizationActive
United States Navy
NPI 1306395280 · Dentist · Jacksonville, FL
Provider details
- NPI number
- 1306395280
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Peter Ruocco, Commanding Officer(760) 725-5208
- License
- 7136-15 (WI)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Building H 2005 Knight Lane
Navy Medicine Support Command Attn: Medical Staff Svcs
Jacksonville, FL 32212-0140
Phone: (760) 725-3213
Approximate (ZIP-level) locationGet directions
Mailing address
853 Valley Ave
Solana Beach, CA 92075-2492
Registry dates
- Enumerated
- 2016-10-03
- Last updated
- 2016-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.