NPIMap

Organization Active NPI

The Main Street Dentists Inc

  • Dentist
  • Leesburg, FL
National Provider Identifier
1265500565
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0014763 Issued in FL
Legal business name
THE MAIN STREET DENTISTS INC
Practice address
606 W Magnolia Street
Leesburg, FL 34748
Phone
(352) 787-4800
Fax
(352) 787-9091
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Dr. Jon David Mehr, DDSNPI 1720379811
Title
Dr & President of Corporation
Phone
(352) 787-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN0014763 FL Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN0014896 FL

Addresses

Primary practice location

606 W Magnolia Street
Leesburg, FL 34748

Mailing address

606 W Magnolia Street
Leesburg, FL 34748
Phone (352) 787-4800

Other identifiers 4

IdentifierTypeStateIssuer
1364448OtherUNITED CONCORDIA
36839OtherBLUE CROSS BLUE SHIELD
749700OtherUNITED CONCORDIA
36838OtherBLUE CROSS BLUE SHIELD

Other names 1

  • Jon David Mehr DDS & Martha Bridges Mehr DDS Other name

National Provider Directory

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1265500565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 W MAGNOLIA STREET",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34748",
            "telephone_number": "352-787-4800",
            "fax_number": "352-787-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 W MAGNOLIA STREET",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34748",
            "telephone_number": "352-787-4800",
            "fax_number": "352-787-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MAIN STREET DENTISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "MEHR",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DR & PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "352-787-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0014763",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0014896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1364448",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36839",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "749700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36838",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jon David Mehr DDS & Martha Bridges Mehr DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.