NPIMap

Organization Active NPI

Jila J.Mahajan, D.D.S.L.L.C

  • Pediatric Dentistry
  • Jacksonville, FL
National Provider Identifier
1518369115
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN13919 Issued in FL
Legal business name
JILA J.MAHAJAN, D.D.S.L.L.C
Practice address
4495 Roosevelt Blvd Ste 111
Jacksonville, FL 32210-3382
Phone
(904) 423-1377
NPI assigned
Sep 25, 2014
Organization subpart
Yes
Parent organization
KIDS FIRST DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Jila J Mahajan, DDSNPI 1780734251
Title
Manager/Owner
Phone
(904) 423-1377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DN13919 FL Primary

Addresses

Primary practice location

4495 Roosevelt Blvd Ste 111
Jacksonville, FL 32210-3382

Mailing address

4495 Roosevelt Blvd Ste 111
Jacksonville, FL 32210-3382
Phone (904) 423-1377

National Provider Directory

National Provider Directory
Part of
Kids First Dentistryinc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1518369115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4495 ROOSEVELT BLVD STE 111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103382",
            "telephone_number": "904-423-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4495 ROOSEVELT BLVD STE 111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103382",
            "telephone_number": "904-423-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILA J.MAHAJAN, D.D.S.L.L.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIDS FIRST DENTISTRY",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "MAHAJAN",
        "authorized_official_first_name": "JILA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "904-423-1377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN13919",
            "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 Sep 25, 2014; 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.