Christopher Wright Latham, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

18401 Issued in FL

Practice address

2047 Park St
Jacksonville, FL 32204-3809

Phone

(904) 388-7665

NPI assigned

Jul 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Imray & Gesek DMD PA

  • Dentist
  • Jacksonville, FL
  • NPI 1114065133
  NPD (past)
• Jacksonville Oral Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Jacksonville, FL
  • NPI 1871123984
  NPD (past)

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1831353747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2047 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043809",
            "telephone_number": "904-388-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2047 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043809",
            "telephone_number": "904-388-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "CHRISTOPHER",
        "middle_name": "WRIGHT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "D12636",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "56616",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "18401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Elizabeth Lasure, DPT
• Kristina M Laszczak, PT
• Keith Latasiewicz, DNP-CRNA
• Azalfa Uzair Lateef
• Audra Elisabeth Latham, LMHC
• Kathleen Lathram
• Mark Lathrop, CRNA
• Benjamin Latimer, PA
• Linda Latimer, LMHC
• Herbert W Latney Jr., LMHC

• Oral & Maxillofacial Surgery (D.M.D.) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.