Justin McDaniel, MSD, DMD, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN20940 Issued in FL

Practice address

7410 Merrill Rd Ste 2
Jacksonville, FL 32277-6547

Phone

(904) 619-7140

NPI assigned

Oct 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ortho 99 Plus 1

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jacksonville, FL
  • NPI 1609408574
  NPD Authorized official
• Ortho 99 Plus 1 Bartram Park LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jacksonville, FL
  • NPI 1699432468
  NPD Authorized official
• Ortho 99 Plus 1 Beach LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jacksonville, FL
  • NPI 1144902719
  NPD Authorized official
• Ortho 99 Plus 1 Orange Park LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Orange Park, FL
  • NPI 1790518421
  NPD Authorized official

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1285038786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 MERRILL RD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322776547",
            "telephone_number": "904-619-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 MERRILL RD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322776547",
            "telephone_number": "904-619-7140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 Mallory Cir",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Celebration",
            "state": "FL",
            "postal_code": "347471818",
            "country_code": "US",
            "telephone_number": "407-566-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MSD, DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20940",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN20940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gavin James McCutcheon, D.C.
• Sharon R McDade, A.N.P. - B.C.
• Tracy McDade, LCSW
• Jennifer McDaniel-Tandron, ARNP
• Brandy McDaniel, D.P.T
• Layla Brock McDaniel, PA-C
• Loviya McDaniel
• Sean Michael McDaniel, PSYD
• Tana McDaniel, NP
• Tara Brinson McDaniel, CCMA

• Orthodontics and Dentofacial Orthopedics Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.