Active NPI
Valerie Kimberley Ligeon, DDS
- General Practice Dentistry
- Jacksonville, FL
National Provider Identifier
1366850018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN 20837
- Practice address
- 9978 Old Baymeadows Rd Ste 1
Jacksonville, FL 32256-7960 - Phone
- (904) 620-7319
- Fax
- (904) 620-7319
- NPI assigned
- Jul 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN 20837 | FL | Primary |
Addresses
Primary practice location
9978 Old Baymeadows Rd Ste 1
Jacksonville, FL 32256-7960
Mailing address
8450 Gate Pkwy W Unit 1408
Jacksonville, FL 32216-1072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150602002494 | FL | Order and Referring Only - Dentist | 3173844164 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 20837 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1366850018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8450 GATE PKWY W UNIT 1408",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9978 OLD BAYMEADOWS RD STE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322567960",
"telephone_number": "904-620-7319",
"fax_number": "904-620-7319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGEON",
"first_name": "VALERIE",
"middle_name": "KIMBERLEY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-25",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN 20837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.