Individual provider Active NPI

Suvana Hashim, DDS

  • General Practice Dentistry
  • Jacksonville Beach, FL
National Provider Identifier
1447684493
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN28758 Issued in FL
Practice address
2218 3Rd St S
Jacksonville Beach, FL 32250-4021
Phone
(904) 441-0632
NPI assigned
Aug 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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 DN28758 FL Primary

Addresses

Primary practice location

2218 3Rd St S
Jacksonville Beach, FL 32250-4021

Mailing address

2218 3Rd St S
Jacksonville Beach, FL 32250-4021
Phone (904) 441-0632

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
DN28758FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Dental - Jacksonville Beach Dentist CurrentSince Jan 28, 2024 Accepting new patients

Locations

2218 3rd St S
Jacksonville Beach, FL 32250
Phone (786) 720-0911

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.

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1447684493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 3RD ST S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504021",
            "telephone_number": "904-441-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 3RD ST S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504021",
            "telephone_number": "904-441-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASHIM",
        "first_name": "SUVANA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.