RDC Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN17040 Issued in FL

Legal business name

RDC DENTAL PA

Practice address

305 E Union St
Jacksonville, FL 32202-2748

Phone

(904) 717-9161

Fax

(904) 717-9167

NPI assigned

Apr 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Rafael D Cepeda, DDSNPI 1205084472

Title

President

Phone

(904) 717-9161

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DDS DENTAL CENTER 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.

• Rafael D Cepeda, DDS

  • Dentist
  • Jacksonville, FL
  • NPI 1205084472
  NPD (past) Authorized official

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1669979639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E UNION ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022748",
            "telephone_number": "904-717-9161",
            "fax_number": "904-717-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E UNION ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022748",
            "telephone_number": "904-717-9161",
            "fax_number": "904-717-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RDC DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "CEPEDA",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-717-9161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN17040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003095300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DDS DENTAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DDS DENTAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rana S Raza
• Rishi Norman Razdan, MD
• Ilona Vladovna Razgauskayte, APRN
• Abdur Raziq, MD
• Shay Razmi
• Emily Lisa Rea, ARNP
• Amy D Read, LCSW
• Jason Thomas Read, M.D
• Steven Craig Read, D.C.
• Sara Dwyer Reader, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.