Affordable Braces of North Florida

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN19187 Issued in FL

Legal business name

AFFORDABLE BRACES OF NORTH FLORIDA

Doing business as

Affordable Braces

Practice address

559 W Twincourt TRL
Suite 602
St Augustine, FL 32095-8805

Phone

(404) 414-0106

NPI assigned

Nov 29, 2015

Last updated

Nov 29, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason P Ouellette, DDSNPI 1891027181

Title

Owner - Orthodontist

Phone

(404) 414-0106

Specialties & licenses 1

Addresses

Other names 1

• Affordable Braces Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Patrick Ouellette, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Merritt Island, FL
  • NPI 1891027181
  NPD (past) Authorized official

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

{
    "created_epoch": "1448755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448755200000",
    "number": "1538533674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 W TWINCOURT TRL",
            "address_2": "SUITE 602",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958805",
            "telephone_number": "404-414-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 W TWINCOURT TRL",
            "address_2": "SUITE 602",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958805",
            "telephone_number": "404-414-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE BRACES OF NORTH FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-29",
        "last_updated": "2015-11-29",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER - ORTHODONTIST",
        "authorized_official_telephone_number": "404-414-0106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN19187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Julia Affronti, MS, CF-SLP
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• Sarah Kathleen Agee, FNP-BC, BSN, RN
• Ashley Agnew, APRN
• Olivia Leigh Agnew

• Orthodontics and Dentofacial Orthopedics Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

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