NPIMap

Organization Active NPI

Economy Dentistry Dupont Station

  • Dental Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1124364971
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN8243 Issued in FL
Legal business name
ECONOMY DENTISTRY DUPONT STATION
Practice address
3615 Dupont Ave
200-400
Jacksonville, FL 32217-2790
Phone
(904) 714-6939
Fax
(904) 751-9196
NPI assigned
Dec 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Authorized official

Name
Dr. Leroy Ronald Polite, D.M.D
Title
President
Phone
(904) 714-6939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN8243 FL Primary

Addresses

Primary practice location

3615 Dupont Ave
200-400
Jacksonville, FL 32217-2790

Mailing address

3615 Dupont Ave
200-400
Jacksonville, FL 32217-2790
Phone (904) 714-6939

National Provider Directory

National Provider Directory
Tax ID family
Economy Dentistry for Children - Dupont Station LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1124364971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 DUPONT AVE",
            "address_2": "200-400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172790",
            "telephone_number": "904-714-6939",
            "fax_number": "904-751-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 DUPONT AVE",
            "address_2": "200-400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172790",
            "telephone_number": "904-714-6939",
            "fax_number": "904-751-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECONOMY DENTISTRY DUPONT STATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "POLITE",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-714-6939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN8243",
            "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 Dec 26, 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.