NPIMap

Organization Active NPI

Smiling Kidds Dentistry, P.a.

  • Pediatric Dentistry
  • Jacksonville, FL
National Provider Identifier
1255937686
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SMILING KIDDS DENTISTRY, P.A.
Practice address
9857 Old Saint Augustine Rd Ste 3
Jacksonville, FL 32257-8821
Phone
(904) 880-5437
NPI assigned
Dec 10, 2020
Organization subpart
Yes
Parent organization
SMILING KIDDS DENTISTRY, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Andrew Weaver
Title
Administrator
Phone
(904) 395-7772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

9857 Old Saint Augustine Rd Ste 3
Jacksonville, FL 32257-8821

Mailing address

3020 Hartley Rd Ste 210
Jacksonville, FL 32257-8206

Other names 1

  • River City Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Smiling Kidds Dentistry PA8 organizations share this tax ID, including this one
Part of
Smiling Kidds Dentistry PA

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1255937686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HARTLEY RD STE 210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9857 OLD SAINT AUGUSTINE RD STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578821",
            "telephone_number": "904-880-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILING KIDDS DENTISTRY, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMILING KIDDS DENTISTRY, P.A.",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-395-7772"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River City Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "River City Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 26, 2021; 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.