David F Randolph DMD PA

Primary specialty

DentistTaxonomy code 122300000X

License

9899 Issued in FL

Legal business name

DAVID F RANDOLPH DMD PA

Practice address

1779 SW Barnett Way Ste 101
Lake City, FL 32025-6957

Phone

(386) 755-4033

Fax

(386) 755-2581

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

David F RandolphNPI 1881715795

Title

Dentist

Phone

(386) 755-4033

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• David F Randolph, DMD

  • Dentist
  • Lake City, FL
  • NPI 1881715795
  NPD (past) Authorized official

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1528189446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 SW BARNETT WAY STE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256957",
            "telephone_number": "386-755-4033",
            "fax_number": "386-755-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 SW BARNETT WAY STE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256957",
            "telephone_number": "386-755-4033",
            "fax_number": "386-755-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID F RANDOLPH DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "386-755-4033"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "9899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60390",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Daniels
• Kelly Olivia Daniels
• Yen Margaret Dao Barnes
• Danielle F Darling, PTA
• David C Terrell Jr Arnp, PA
• David G Fanney, DO PA
• Tracie Lynn David-Dean, RN, BSN
• Andrea Lechele Davis
• Cynthia Suzanne Davis, PTA
• Jennifer Ashley Davis, MSW, LCSW

• Dentist in Lake City, FL
• Providers in Lake City, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.