Organization Active NPI

Affordable Dentures & Implants - Florida, PLLC

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1316536402
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - FLORIDA, PLLC
Practice address
800 Dunn Ave
Jacksonville, FL 32218-4803
Phone
(904) 240-1941
NPI assigned
Jan 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Charles Gillam, DMD
Title
Owner
Phone
(904) 240-1941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

800 Dunn Ave
Jacksonville, FL 32218-4803

Mailing address

800 Dunn Ave
Jacksonville, FL 32218-4803
Phone (904) 240-1941

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentures Implants - Florida PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1316536402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184803",
            "telephone_number": "904-240-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184803",
            "telephone_number": "904-240-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - FLORIDA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "GILLAM",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-240-1941",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 13, 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.