J. Wayne Delucia D.D.S., P.a.

Primary specialty

Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X

License

DN7365 Issued in FL

Legal business name

J. WAYNE DELUCIA D.D.S., P.A.

Practice address

14185 Beach Blvd Ste 2
Jacksonville, FL 32250-1574

Phone

(904) 223-9999

NPI assigned

Mar 18, 2007

Last updated

Aug 22, 2020By 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. Joseph Wayne Delucia, D.D.S.

Title

President

Phone

(904) 223-9999

Specialties & licenses 1

Addresses

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.

• Michael Wayne Delucia, DMD

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1306072863
  NPD (past)

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588788434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14185 BEACH BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501574",
            "telephone_number": "904-223-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14185 BEACH BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501574",
            "telephone_number": "904-223-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. WAYNE DELUCIA D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELUCIA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-223-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "FL",
            "license": "DN7365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinic/Center in Florida

• 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.