Organization Active NPI

Affordable Dentures -Jacksonville, P.C.

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1508995036
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN16271 Issued in FL
Legal business name
AFFORDABLE DENTURES -JACKSONVILLE, P.C.
Practice address
10503 San Jose Blvd
Suite 10
Jacksonville, FL 32257-6295
Phone
(904) 262-3695
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Adrian A Attkisson, DMD
Title
Owner
Phone
(904) 262-3695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN16271 FL Primary

Addresses

Primary practice location

10503 San Jose Blvd
Suite 10
Jacksonville, FL 32257-6295

Mailing address

10503 San Jose Blvd
Suite 10
Jacksonville, FL 32257-6295
Phone (904) 262-3695

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentures-Jacksonville PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10503 San Jose Blvd
Ste 10
Jacksonville, FL 32257
Phone (904) 262-3695

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508995036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10503 SAN JOSE BLVD",
            "address_2": "SUITE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576295",
            "telephone_number": "904-262-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10503 SAN JOSE BLVD",
            "address_2": "SUITE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576295",
            "telephone_number": "904-262-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES -JACKSONVILLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ATTKISSON",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-262-3695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16271",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.