Organization Active NPI

H. Raymond Klein, D.D.S., P.a.

  • Pediatric Dentistry
  • Jacksonville, FL
National Provider Identifier
1497893697
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN3351 Issued in FL
Legal business name
H. RAYMOND KLEIN, D.D.S., P.A.
Practice address
943 Cesery Blvd
Jacksonville, FL 32211-5635
Phone
(904) 743-2000
Fax
(904) 725-8569
NPI assigned
Feb 1, 2007
Last updated
Jul 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
H. Raymond Klein, D.D.S.
Title
Pres.
Phone
(904) 743-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN3351 FL Primary

Addresses

Primary practice location

943 Cesery Blvd
Jacksonville, FL 32211-5635

Mailing address

943 Cesery Blvd
Jacksonville, FL 32211-5635
Phone (904) 743-2000

Other identifiers 2

IdentifierTypeStateIssuer
073459400MedicaidFL
071684700MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1497893697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 CESERY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115635",
            "telephone_number": "904-743-2000",
            "fax_number": "904-725-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 CESERY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115635",
            "telephone_number": "904-743-2000",
            "fax_number": "904-725-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. RAYMOND KLEIN, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "H.",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "904-743-2000",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN3351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073459400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071684700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.