Individual provider Active NPI

John D Zongker, D.D.S.

  • Endodontics
  • Jacksonville, FL
National Provider Identifier
1154455277
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN0012231 Issued in FL
Practice address
9770 Old Baymeadows Rd
Ste. 113
Jacksonville, FL 32256-7909
Phone
(904) 636-8999
Fax
(904) 998-7804
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN0012231 FL Primary

Addresses

Primary practice location

9770 Old Baymeadows Rd
Ste. 113
Jacksonville, FL 32256-7909

Mailing address

9770 Old Baymeadows Rd
Ste. 113
Jacksonville, FL 32256-7909
Phone (904) 636-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN0012231FLMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154455277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9770 OLD BAYMEADOWS RD",
            "address_2": "STE. 113",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567909",
            "telephone_number": "904-636-8999",
            "fax_number": "904-998-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9770 OLD BAYMEADOWS RD",
            "address_2": "STE. 113",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567909",
            "telephone_number": "904-636-8999",
            "fax_number": "904-998-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZONGKER",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN0012231",
            "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 Jul 8, 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.