Individual provider Active NPI

Gladys N Mota de Cedano

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1750173944
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN30324 Issued in FL
Practice address
9995 Gate Pkwy N Ste 310
Jacksonville, FL 32246-4482
Phone
(904) 820-2979
NPI assigned
May 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN30324 FL Primary
General Practice Dentistry 1223G0001X 22DI03091500 NJ

Addresses

Primary practice location

9995 Gate Pkwy N Ste 310
Jacksonville, FL 32246-4482

Mailing address

1023 Neck LN Unit 320
Elizabeth, NJ 07201-3437
Phone (347) 789-0263

Other practice location 1

1023 Neck Ln Unit 320
Elizabeth, NJ 07201-3437
Phone (347) 789-0263

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
DN30324FLMDGeneral Practice Dentistry
22DI03091500NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1750173944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 NECK LN UNIT 320",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072013437",
            "telephone_number": "347-789-0263",
            "fax_number": "347-789-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9995 GATE PKWY N STE 310",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464482",
            "telephone_number": "904-820-2979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1023 Neck Ln Unit 320",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072013437",
            "country_code": "US",
            "telephone_number": "347-789-0263",
            "fax_number": "347-789-0263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTA DE CEDANO",
        "first_name": "GLADYS",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN30324",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI03091500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.