Active NPI
Dan E. Skaggs, D.D.S.
- General Practice Dentistry
- Orange Park, FL
National Provider Identifier
1740319037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN0014091
- Practice address
- 1845 Eastwest Pkwy
Suite 3 & 4
Orange Park, FL 32003-6405 - Phone
- (904) 278-7308
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN0014091 | FL | Primary |
Addresses
Primary practice location
1845 Eastwest Pkwy
Suite 3 & 4
Orange Park, FL 32003-6405
Mailing address
1845 Eastwest Pkwy
Suite 3 & 4
Orange Park, FL 32003-6405
Phone (904) 278-7308
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN0014091 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341964800000",
"number": "1740319037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1845 EASTWEST PKWY",
"address_2": "SUITE 3 & 4",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320036405",
"telephone_number": "904-278-7308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 EASTWEST PKWY",
"address_2": "SUITE 3 & 4",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320036405",
"telephone_number": "904-278-7308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKAGGS",
"first_name": "DAN",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2012-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN0014091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.