Active NPI
Mark Everett Dawley, DMD
- General Practice Dentistry
- Callahan, FL
National Provider Identifier
1821144205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN12304
- Practice address
- 449621 US Highway 301
Suite 210
Callahan, FL 32011-9348 - Phone
- (904) 879-1893
- Fax
- (904) 879-6448
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- No
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 | DN12304 | FL | Primary |
Addresses
Primary practice location
449621 US Highway 301
Suite 210
Callahan, FL 32011-9348
Mailing address
3545-1 St. Johns Bluff Rd. S.
Suite 352
Jacksonville, FL 32224
Phone (904) 998-7000
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 |
|---|---|---|---|
| DN12304 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Callahan Health Group Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Preferred Provider Organization
- Callahan, FL
- NPI 1891958393
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1821144205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3545-1 ST. JOHNS BLUFF RD. S.",
"address_2": "SUITE 352",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32224",
"telephone_number": "904-998-7000",
"fax_number": "904-998-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "449621 US HIGHWAY 301",
"address_2": "SUITE 210",
"city": "CALLAHAN",
"state": "FL",
"postal_code": "320119348",
"telephone_number": "904-879-1893",
"fax_number": "904-879-6448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWLEY",
"first_name": "MARK",
"middle_name": "EVERETT",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN12304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Callahan, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.