Matthew Jurcak, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

30024538 Issued in OH

Practice address

2005 Knight Lane BLDG H Navy Medicine Support Command
Attn: Medical Staff SVCS
Jacksonville, FL 32212-0140

Phone

(760) 725-3213

NPI assigned

Jul 17, 2015

Sex

Male

Sole proprietor

No

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.

• United States Navy

  • Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
  • Jacksonville, FL
  • NPI 1043632771
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2015.

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1508240656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS",
            "address_2": "BLDG H 2005 KNIGHT LANE",
            "city": "FPO",
            "state": "AA",
            "postal_code": "322120140",
            "telephone_number": "760-725-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H NAVY MEDICINE SUPPORT COMMAND",
            "address_2": "ATTN: MEDICAL STAFF SVCS",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "760-725-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURCAK",
        "first_name": "MATTHEW",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30024538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jacksonville, FL
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.