Individual provider Active NPI

Jeffrey B. Schultz, D.D.S.

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1407867237
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10974 Issued in FL
Practice address
9310 Old Kings Rd S
BLDG. 601
Jacksonville, FL 32257-6152
Phone
(904) 737-8081
Fax
(904) 737-3343
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN10974 FL Primary

Addresses

Primary practice location

9310 Old Kings Rd S
BLDG. 601
Jacksonville, FL 32257-6152

Mailing address

9310 Old Kings Rd S
BLDG. 601
Jacksonville, FL 32257-6152
Phone (904) 737-8081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN10974FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407867237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 OLD KINGS RD S",
            "address_2": "BLDG. 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576152",
            "telephone_number": "904-737-8081",
            "fax_number": "904-737-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 OLD KINGS RD S",
            "address_2": "BLDG. 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576152",
            "telephone_number": "904-737-8081",
            "fax_number": "904-737-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "JEFFREY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10974",
            "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 Jul 8, 2007; 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.