Palm Leaf Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18137 Issued in FL

Legal business name

PALM LEAF DENTAL

Practice address

100 Marketside Ave Ste 306
Ponte Vedra, FL 32081-0582

Phone

(904) 810-5702

NPI assigned

Mar 24, 2014

Organization subpart

No

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

Authorized official

Name

Aaron Evens

Title

Owner

Phone

(904) 810-5702

Specialties & licenses 1

Addresses

Tax ID family

Community Therapy LLC2 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.

• Community Therapy LLC

  • Speech-Language Pathologist
  • Lakewood, NJ
  • NPI 1346656659
  NPD tax ID

Locations

Practitioners 1

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

• Sarah J Georges, DMD

  • General Practice Dentistry
  • Ponte Vedra Beach, FL
  • NPI 1841783222
  NPD (past)

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1609293034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARKETSIDE AVENUE, STE 306",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "32081",
            "telephone_number": "904-810-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARKETSIDE AVE STE 306",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810582",
            "telephone_number": "904-810-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM LEAF DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "EVENS",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-810-5702"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ohw Ventures LLC (Ponte Vedra Spine and Pain Center)
• Cecilia C. Olazar, M.D.
• Sonya Marie Olsen, M.S., CCC-SLP
• Adepeju Ibironke Faboro Oshaughnessy, L.M.H.C, L.P.C.
• Alicia Ana Otero, MA; CCC-SLP
• Avelina Paly
• Pamela J. Skaff DDS (Dental Design)
• Yuval Adrash Dinesh Patel, M.D.
• Patterson Behavioral Health LLC
• Devon Patterson, PHD

• General Practice Dentistry in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.