Active NPI
Beth E. Kailes, DMD
- Pediatric Dentistry
- Orange Park, FL
National Provider Identifier
1427129790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 16753
- Practice address
- 1998 Rivergate Dr
Orange Park, FL 32003-8686 - Phone
- (904) 541-1444
- Fax
- (904) 541-1444
- NPI assigned
- Nov 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 16753 | FL | Primary |
Addresses
Primary practice location
1998 Rivergate Dr
Orange Park, FL 32003-8686
Mailing address
2245 Plantation Center Dr
Suite 36
Orange Park, FL 32003-3352
Phone (904) 215-7800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16753 | FL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beth E. Kailes, DMD, PA | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Fleming Island, FL
- NPI 1386044790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427129790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2245 PLANTATION CENTER DR",
"address_2": "SUITE 36",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320033352",
"telephone_number": "904-215-7800",
"fax_number": "904-215-7887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1998 RIVERGATE DR",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320038686",
"telephone_number": "904-541-1444",
"fax_number": "904-541-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAILES",
"first_name": "BETH",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "16753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, 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.