NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, P.a.

Doing business as Durbin Creek Dental Care

  • General Practice Dentistry
  • Saint Johns, FL
National Provider Identifier
1093378713
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Doing business as
Durbin Creek Dental Care
Practice address
70 Durbin Pavilion Dr Ste 112
Saint Johns, FL 32259-4109
Phone
(904) 495-7509
NPI assigned
Apr 18, 2019
Last updated
Jun 18, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

70 Durbin Pavilion Dr Ste 112
Saint Johns, FL 32259-4109

Mailing address

70 Durbin Pavilion Dr Ste 112
Saint Johns, FL 32259-4109
Phone (904) 325-7276

Other names 1

  • Durbin Creek Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionals PA457 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionals PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

70 Durbin Pavilion Dr
Ste 112
St Johns, FL 32259
Phone (904) 325-7276

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1093378713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DURBIN PAVILION DR STE 112",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594109",
            "telephone_number": "904-325-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DURBIN PAVILION DR STE 112",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594109",
            "telephone_number": "904-495-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Durbin Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Durbin Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.