Bartram Park Dental,PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN16471 Issued in FL

Legal business name

BARTRAM PARK DENTAL,PA

Practice address

13241 Bartram Park Blvd
Suite # 401
Jacksonville, FL 32258-5212

Phone

(904) 553-8791

NPI assigned

Jul 29, 2007

Last updated

Jul 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George A Varghese, DDSNPI 1598955205

Title

President

Phone

(904) 553-8791

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• George A Varghese, DDS

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1598955205
  NPD (past) Authorized official

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

{
    "created_epoch": "1185667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185667200000",
    "number": "1144410853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD",
            "address_2": "SUITE # 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD",
            "address_2": "SUITE # 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585212",
            "telephone_number": "904-553-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTRAM PARK DENTAL,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-29",
        "last_updated": "2007-07-29",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-553-8791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Barton, LMHC
• Wendy Marie Barton, NP
• William P Barton, M.D.
• Bartram Chiropractic Inc
• Bartram Family Chiropractic Inc
• Bartram Park Family ENT, P.a.
• Anjanjyoti Baruah, OTR/L
• Christopher Barusya, MBCHB
• Lisa Basarab
• Christopher Basco

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2007; 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.