Stephanie Burgess Chaves, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20398 Issued in FL

Practice address

10601 San Jose Blvd
Suite 116
Jacksonville, FL 32257-8232

Phone

(904) 483-3027

NPI assigned

Sep 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1144655143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 RIVERSIDE AVE",
            "address_2": "APT. 5207",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044428",
            "telephone_number": "304-290-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 SAN JOSE BLVD",
            "address_2": "SUITE 116",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578232",
            "telephone_number": "904-483-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVES",
        "first_name": "STEPHANIE",
        "middle_name": "BURGESS",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009691200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anil Chauhan, MD
• Mohit Chauhan, MBBS
• John R Chauvin, M.D.
• Harold Enrique Chaves Cardona, MD
• Clara Ines Chaves, M.D.
• Myrah N Chavez, DNP, CRNA
• Mainelys Chaviano Alfonso, APRN
• Disleidys Chaviano, ARNP, FNP-C
• Melissa Chavis
• Nicholas Chavis

• 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 Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.