Andrew L. Skigen DMD PA

Key facts

NPI

1164814596

Entity type

Organization (NPI type 2)

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.) 204E00000X

License

DN14048 (FL)

Legal business name

ANDREW L. SKIGEN DMD PA

Practice address

8708 Perimeter Park Blvd
Suite #1
Jacksonville, FL 32216-6354

Phone

(904) 565-1505

Fax

(904) 565-1506

NPI assigned

Feb 23, 2015

Organization subpart

No

Authorized official

Name

Dr. Andrew L Skigen, DMD

Title

Surgeon

Phone

(904) 565-1505

National Provider Directory

Specialties & licenses

Addresses

Other names

• First Coast Oral & Maxillofacial Surgery Other name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 3, 2015.

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1164814596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 PERIMETER PARK BLVD",
            "address_2": "SUITE #1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161107",
            "telephone_number": "904-565-1505",
            "fax_number": "904-565-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 PERIMETER PARK BLVD",
            "address_2": "SUITE #1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166354",
            "telephone_number": "904-565-1505",
            "fax_number": "904-565-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW L. SKIGEN DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "SKIGEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "904-565-1505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "DN14048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Coast Oral & Maxillofacial Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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