Blue Sky Dental Group, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN21709 Issued in FL

Legal business name

BLUE SKY DENTAL GROUP, LLC

Practice address

14866 Old St. Augustine Rd
Suite 111 and 112
Jacksonville, FL 32288

Phone

(904) 229-5794

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Jonas Ashbaugh, DDSNPI 1154677730

Title

Ceo

Phone

(904) 229-5794

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jonas J Ashbaugh, DDS

  • Dentist
  • Fort Leavenworth, KS
  • NPI 1154677730
  NPD (past) Authorized official

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1720436157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14866 OLD ST. AUGUSTINE RD",
            "address_2": "SUITE 111 AND 112",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14866 OLD ST. AUGUSTINE RD",
            "address_2": "SUITE 111 AND 112",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32288",
            "telephone_number": "904-229-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "ASHBAUGH",
        "authorized_official_first_name": "JONAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-229-5794",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.