Community Dental Constulants, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN19044 Issued in FL

Legal business name

COMMUNITY DENTAL CONSTULANTS, LLC

Practice address

3791 Palm Valley Rd
Suite 204
Ponte Vedra Beach, FL 32082-4182

Phone

(904) 673-5869

Fax

(904) 834-2737

NPI assigned

Jun 28, 2016

Last updated

Jun 28, 2016By 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. David James Yoder, DDSNPI 1215257381

Title

President

Phone

(904) 673-5869

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.

• David James Yoder, DDS

  • Dentist
  • Ponte Vedra Beach, FL
  • NPI 1215257381
  Authorized official Same address or phone

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1619328986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3791 PALM VALLEY RD",
            "address_2": "SUITE 204",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824182",
            "telephone_number": "904-673-5869",
            "fax_number": "904-834-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 PALM VALLEY RD",
            "address_2": "SUITE 204",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824182",
            "telephone_number": "904-673-5869",
            "fax_number": "904-834-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL CONSTULANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-673-5869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.