Bright Smiles Pediatric Dentistry Nassau LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BRIGHT SMILES PEDIATRIC DENTISTRY NASSAU LLC

Doing business as

Bright Smiles Pediatric Dentistry

Practice address

960135 Gateway Blvd
Fernandina Beach, FL 32034-9120

Phone

(904) 584-9004

NPI assigned

Jul 17, 2020

Last updated

Jul 17, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

BRIGHT SMILES PEDIATRIC DENTISTRY NASSAU LLCAs reported in NPPES

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

Authorized official

Name

Stacey Veal, MHA

Title

Practice Manager

Phone

(904) 584-9004

Specialties & licenses 1

Addresses

Other names 1

• Bright Smiles Pediatric Dentistry Doing business as

Part of

Bright Smiles Pediatric Dentistry Nassau LLC

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.

• Matthew Bright, D.M.D.

  • Pediatric Dentistry
  • Saint Johns, FL
  • NPI 1356755474
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1710595509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 EVEREST LN STE 1",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594103",
            "telephone_number": "904-584-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960135 GATEWAY BLVD",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320349120",
            "telephone_number": "904-584-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SMILES PEDIATRIC DENTISTRY NASSAU LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHT SMILES PEDIATRIC DENTISTRY NASSAU LLC",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "VEAL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "904-584-9004",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Smiles Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard E. Braun, MD
• Nicholas John Bremer, M.D.
• Bridges Behavioral Consulting
• Karisa Bridwell
• Robin Briggs, PAC
• Broad River Rehabilitation (Broad River Rehab)
• Charlesetta Nicole Brown, APRN
• Mark A Brown, DC
• Bruce S. West
• Jessica Anne Bruland, APRN

• Pediatric Dentistry in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.