Individual provider Active NPI

Vladimir R Jovic, DMD

  • Prosthodontics
  • Jacksonville, FL
National Provider Identifier
1023290889
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN17952 Issued in FL
Practice address
10991 San Jose Blvd Ste 54
Jacksonville, FL 32223-6655
Phone
(904) 268-0606
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22020 MA
Prosthodontics 1223P0700X DN17952 FL Primary

Addresses

Primary practice location

10991 San Jose Blvd Ste 54
Jacksonville, FL 32223-6655

Mailing address

1701 The Greens Way
#1222
Jacksonville Beach, FL 32250-2480
Phone (407) 592-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22020MAMDDentist
DN17952FLMDProsthodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1023290889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 THE GREENS WAY",
            "address_2": "#1222",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502480",
            "telephone_number": "407-592-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10991 SAN JOSE BLVD STE 54",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236655",
            "telephone_number": "904-268-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOVIC",
        "first_name": "VLADIMIR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "22020",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN17952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.