John Landis DDS, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

JOHN LANDIS DDS, PA

Practice address

472 Jacksonville Dr
Jacksonville Beach, FL 32250-3812

Phone

(904) 246-6545

Fax

(904) 246-3718

NPI assigned

Nov 30, 2018

Organization subpart

No

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

Authorized official

Name

Dr. John Frederick Landis, DDSNPI 1043453723

Title

DDS

Phone

(904) 246-6545

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Frederick Landis, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Jacksonville Beach, FL
  • NPI 1043453723
  NPD Authorized official

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1447720651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503812",
            "telephone_number": "904-246-6545",
            "fax_number": "904-246-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503812",
            "telephone_number": "904-246-6545",
            "fax_number": "904-246-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN LANDIS DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "LANDIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "904-246-6545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.