Ponte Vedra Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PONTE VEDRA ORTHODONTICS LLC

Practice address

3109 Sawgrass Village Cir
Ponte Vedra Beach, FL 32082-5032

Phone

(904) 273-9115

Fax

(904) 871-8116

NPI assigned

Feb 11, 2025

Organization subpart

No

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

Authorized official

Name

Merrian Refuerzo

Title

Billing Manager

Phone

(321) 609-7241

Specialties & licenses 1

Addresses

Practitioners 2

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

• Zubad Newaz, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ponte Vedra Beach, FL
  • NPI 1134551823
  NPD
• Randolph J Hayes Jr., D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ponte Vedra Beach, FL
  • NPI 1891845566
  NPD (past)

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1497560023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 SAWGRASS VILLAGE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825032",
            "telephone_number": "904-273-9115",
            "fax_number": "904-871-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 SAWGRASS VILLAGE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825032",
            "telephone_number": "904-273-9115",
            "fax_number": "904-871-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTE VEDRA ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "REFUERZO",
        "authorized_official_first_name": "MERRIAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "321-609-7241"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ponte Vedra Counseling LLC
• Ponte Vedra Endodontics
• Ponte Vedra Family Dentistry
• Ponte Vedra Family Dentistry
• Ponte Vedra Neuropsychology LLC
• Ponte Vedra Physical Therapy, Inc.
• Ponte Vedra Plastic Surgery, Inc
• Ponte Vedra Psychiatry LLC
• Ponte Vedra Psychologists, LLC
• Ponte Vedra Spine Center LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.