Individual provider Active NPI

Michael William Kessler, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ponte Vedra, FL
National Provider Identifier
1720196272
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN0014321 Issued in FL
Practice address
115 Professional Dr
105
Ponte Vedra, FL 32082
Phone
(904) 280-4006
Fax
(904) 280-8700
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN0014321 FL Primary

Addresses

Primary practice location

115 Professional Dr
105
Ponte Vedra, FL 32082

Mailing address

115 Professional Dr
105
Ponte Vedra, FL 32082
Phone (904) 280-4006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN0014321FLMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Oral & Facial Surgery, P.a. Oral and Maxillofacial Surgery PastSince Sep 30, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720196272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PROFESSIONAL DR",
            "address_2": "105",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-280-4006",
            "fax_number": "904-280-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PROFESSIONAL DR",
            "address_2": "105",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-280-4006",
            "fax_number": "904-280-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN0014321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.