NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals. P.a.

  • General Practice Dentistry
  • Yulee, FL
National Provider Identifier
1104306422
Registry record updated Aug 16, 2018
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.
Practice address
463787 State Road 200
Yulee, FL 32097-8652
Phone
(904) 875-4119
NPI assigned
Aug 16, 2018
Last updated
Aug 16, 2018By 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 Aug 16, 2018

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) 540-8426

Specialties & licenses 1

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

Addresses

Primary practice location

463787 State Road 200
Yulee, FL 32097-8652

Mailing address

463787 State Road 200
Yulee, FL 32097-8652
Phone (904) 875-4119

Other names 1

  • Concourse Dental Care Former legal business name

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

463787 State Road 200
Yulee, FL 32097
Phone (904) 875-4119

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1104306422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463787 STATE ROAD 200",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320978652",
            "telephone_number": "904-875-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463787 STATE ROAD 200",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320978652",
            "telephone_number": "904-875-4119"
        }
    ],
    "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": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8426"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concourse Dental Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Yulee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.