NPIMap

Organization Active NPI

JC Dental, LLC

  • Dental Clinic/Center
  • Orange Park, FL
National Provider Identifier
1750006938
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
JC DENTAL, LLC
Practice address
390 Jefferson Ave
Orange Park, FL 32065-7717
Phone
(904) 272-1588
NPI assigned
Oct 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Joshua Chupp, DMDNPI 1689056889
Title
Owner Dentist
Phone
(904) 272-1588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

390 Jefferson Ave
Orange Park, FL 32065-7717

Mailing address

390 Jefferson Ave
Orange Park, FL 32065-7717
Phone (904) 272-1588

National Provider Directory

National Provider Directory

Locations

390 Jefferson Ave
Orange Park, FL 32065
Phone (904) 272-1588

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1750006938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 JEFFERSON AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657717",
            "telephone_number": "904-272-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 JEFFERSON AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657717",
            "telephone_number": "904-272-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "CHUPP",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "904-272-1588",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "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 Nov 9, 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.