NPIMap

Organization Active NPI

United Stated Navy

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1760834980
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8727 Issued in SC
Legal business name
UNITED STATED NAVY
Practice address
BLDG H 2005 Knight Lane
Navy Medicine Support Support Command Attn: Medical Sta
Jacksonville, FL 32212-0140
Phone
(760) 725-3213
NPI assigned
Jul 12, 2016
Last updated
Jul 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Dr. Justin Roger Smith, D.M.D.NPI 1508451485
Title
Dentist
Phone
(770) 241-9192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8727 SC Primary

Addresses

Primary practice location

BLDG H 2005 Knight Lane
Navy Medicine Support Support Command Attn: Medical Sta
Jacksonville, FL 32212-0140

Mailing address

BLDG H 2005 Knight Lane
Navy Medicine Support Support Command Attn: Medical Sta
Jacksonville, FL 32212-0140
Phone (760) 725-3213

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1760834980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG H 2005 KNIGHT LANE",
            "address_2": "NAVY MEDICINE SUPPORT SUPPORT COMMAND ATTN: MEDICAL STA",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "760-725-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG H 2005 KNIGHT LANE",
            "address_2": "NAVY MEDICINE SUPPORT SUPPORT COMMAND ATTN: MEDICAL STA",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "760-725-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED STATED NAVY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-241-9192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8727",
            "primary": true
        }
    ],
    "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 Jul 12, 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.