Individual provider Active NPI

Ana Carolina Machado, DDS

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1073199634
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25654 Issued in FL
Practice address
9109 Baymeadows Rd Ste 1
Jacksonville, FL 32256-1842
Phone
(904) 731-4343
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN25654 FL
General Practice Dentistry 1223G0001X DN25654 FL Primary

Addresses

Primary practice location

9109 Baymeadows Rd Ste 1
Jacksonville, FL 32256-1842

Mailing address

4424 N Alatamaha St
St Augustine, FL 32092-3684
Phone (512) 822-0063

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN25654FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1073199634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 N ALATAMAHA ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923684",
            "telephone_number": "512-822-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 BAYMEADOWS RD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561842",
            "telephone_number": "904-731-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHADO",
        "first_name": "ANA",
        "middle_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25654",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25654",
            "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 Mar 23, 2021; 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.