A Smile Resort, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0010421 Issued in FL

Legal business name

A SMILE RESORT, PA

Practice address

3676 Crown Point CT
Jacksonville, FL 32257-5966

Phone

(904) 268-2011

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Martha G Lay

Title

Office Manager

Phone

(904) 268-2011

Specialties & licenses 2

Addresses

Locations

Practitioners 3

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

• Frank Henry Zimmerman, DMD

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1518577329

  General Practice

  NPD (past)
• Rod S Zimmerman, DDS

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1114939071

  General Practice

  NPD (past)
• Rasha Safaa Kajy, DDS

  • Dentist
  • Clarkston, MI
  • NPI 1215083613
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285844274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 CROWN POINT CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575966",
            "telephone_number": "904-268-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 CROWN POINT CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575966",
            "telephone_number": "904-268-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SMILE RESORT, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAY",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-268-2011",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0010421",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jacksonville, FL
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.