Ponte Vedra Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

PONTE VEDRA ENDODONTICS

Practice address

822 A1A North
Ste 314
Ponte Vedra Beach, FL 32082

Phone

(904) 273-5770

Fax

(904) 701-6252

NPI assigned

Sep 12, 2019

Organization subpart

No

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

Authorized official

Name

Joseph C Mavec, DDS MSNPI 1235162330

Title

DDS / Owner

Phone

(904) 273-5770

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Joseph Charles Mavec, D.D.S., M.S.

  • Endodontics
  • Ponte Vedra Beach, FL
  • NPI 1235162330
  NPD (past) Authorized official
• Robert Timothy Radel, D.M.D., M.S.

  • Endodontics
  • Ponte Vedra Beach, FL
  • NPI 1669473120
  NPD (past)

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1649820630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 A1A NORTH",
            "address_2": "STE 314",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-273-5770",
            "fax_number": "904-701-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 A1A NORTH",
            "address_2": "STE 314",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-273-5770",
            "fax_number": "904-701-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTE VEDRA ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "MAVEC",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DDS / OWNER",
        "authorized_official_telephone_number": "904-273-5770",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ponte Vedra BCH Surgery Clinic
• Ponte Vedra Beach Surgery Center LLC
• Ponte Vedra Chiropractic Medicine & Physical Therapy, Inc.
• Ponte Vedra Cosmetic Dentistry, PA
• Ponte Vedra Counseling LLC (Ponte Vedra Beach Counseling)
• Ponte Vedra Family Dentistry
• Ponte Vedra Family Dentistry
• Ponte Vedra Neuropsychology LLC
• Ponte Vedra Orthodontics LLC
• Ponte Vedra Physical Therapy, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.