Seabreeze Dental Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SEABREEZE DENTAL GROUP PLLC

Practice address

2520 US 1 S
Saint Augustine, FL 32086-6194

Phone

(904) 794-4424

NPI assigned

Nov 8, 2022

Last updated

Nov 15, 2022By 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

Melissa Melissa

Title

Director of Operations

Phone

(904) 794-4424

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1700594892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 US 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866194",
            "telephone_number": "904-794-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 US 1 S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320866194",
            "telephone_number": "904-794-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Royal Palms Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322333921",
            "country_code": "US",
            "telephone_number": "904-251-5342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEABREEZE DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "MELISSA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "904-794-4424"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.