Hirezi Hirezi DMD PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

13089 Issued in FL

Legal business name

HIREZI HIREZI DMD PA

Doing business as

Hirezi Family Dentistry

Practice address

4495 Baymeadows Rd
Jacksonville, FL 32217-4716

Phone

(904) 733-9191

NPI assigned

Jul 30, 2013

Organization subpart

Yes

Parent organization

HIREZI FAMILY DENTISTRYAs reported in NPPES

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

Authorized official

Name

Lottie M Descallar

Title

Practice Adminisrator

Phone

(904) 733-9191

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hirezi Family Dentistry Doing business as

Part of

Hirezi Hirezi DMD PA

Practitioners 1

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

• Nabil Jabra Hirezi, DDS

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1639241821
  NPD (past)

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1679905848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4495 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174716",
            "telephone_number": "904-733-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4495 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174716",
            "telephone_number": "904-733-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIREZI HIREZI DMD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIREZI FAMILY DENTISTRY",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "DESCALLAR",
        "authorized_official_first_name": "LOTTIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISRATOR",
        "authorized_official_telephone_number": "904-733-9191"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "13089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL DENTAL INSURANCE",
            "identifier": "1639241821",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hirezi Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendy Walker Hinton, B.S., MAOM
• Mariah Anne Hiott, CAA
• Alaina Hipke, PT, DPT
• Jennifer Auerbach Hipp, D.O.
• Erika Hires
• Flor Descallar Hirezi, DDS
• Nabil Jabra Hirezi, DDS
• Marek John Hirsch, M.D.
• Miriam Hirschberg, ARNP
• Allison Shepherd Hirtzel, LCSW

• 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 Jul 30, 2013; 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.