Individual provider Active NPI

Alan Margolis

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1861179574
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN29498 Issued in FL
Practice address
651 Nautica Dr Unit 1
Jacksonville, FL 32218-7222
Phone
(904) 423-4014
NPI assigned
Jul 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN29498 FL
General Practice Dentistry 1223G0001X DN29498 FL Primary

Addresses

Primary practice location

651 Nautica Dr Unit 1
Jacksonville, FL 32218-7222

Mailing address

651 Nautica Dr Unit 1
Jacksonville, FL 32218-7222
Phone (904) 423-4014

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
DN29498FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Florida North, PLLC General Practice CurrentSince Jan 12, 2025 Accepting new patients

Locations

651 Nautica Dr
#1
Jacksonville, FL 32218
Phone (904) 423-4014

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.

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1861179574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 NAUTICA DR UNIT 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187222",
            "telephone_number": "904-423-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 NAUTICA DR UNIT 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187222",
            "telephone_number": "904-423-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGOLIS",
        "first_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-04",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29498",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29498",
            "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 Aug 12, 2024; 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.