Organization Active NPI

JW Bolton DDS PA

  • Customized Equipment (DME)
  • Ponte Vedra, FL
National Provider Identifier
1467934919
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
JW BOLTON DDS PA
Practice address
200 Solana Rd
Ponte Vedra, FL 32082-2232
Phone
(904) 273-8881
NPI assigned
Aug 31, 2018
Last updated
Aug 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Authorized official

Name
J W Bolton, DDS
Title
Owner
Phone
(904) 273-8881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

200 Solana Rd
Ponte Vedra, FL 32082-2232

Mailing address

200 Solana Rd
Ponte Vedra, FL 32082-2232
Phone (904) 273-8881

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1467934919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOLANA RD",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320822232",
            "telephone_number": "904-273-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOLANA RD",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320822232",
            "telephone_number": "904-273-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JW BOLTON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "J W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-273-8881",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.