Justine Konane Chase, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN-14797 Issued in FL

Practice address

4579 Hwy 20 E Suite 210
Niceville, FL 32578

Phone

(850) 897-4200

Fax

(850) 897-4504

NPI assigned

Jul 20, 2006

Last updated

Oct 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Justine Konane Vial Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 3, 2020 through Mar 3, 2028

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midbay Dental PPLC

  dba Mid Bay Dental

  • Dentist
  • Niceville, FL
  • NPI 1013376219
  NPD (past) Authorized official
• Mid Bay Dental PLLC

  dba Mid Bay Dental

  • General Practice Dentistry
  • Niceville, FL
  • NPI 1528427739
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1841210267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 HWY 20 E SUITE 210",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-897-4200",
            "fax_number": "850-897-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 HWY 20 E SUITE 210",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-897-4200",
            "fax_number": "850-897-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "JUSTINE",
        "middle_name": "KONANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN-14797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "VIAL",
            "middle_name": "KONANE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eden Leigh Cassidy
• Lori Clark Cathey, RPH
• Candice Brittany Cecil
• Ariell Roxanne Chambers, M.S., CCC-SLP
• Chandler Plastic Surgery
• Esperanza Chayrez-Cabrera, RD, LD
• Sharon Shou Yun Chen, DDS
• Cathy S Cheung, RN
• Allison Chorey
• Lindsey Robin Christian, LCSW

• Dentist in Niceville, FL
• Providers in Niceville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.