NPIMap

Organization Active NPI

Bob W. Deason, DDS, PA

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1861723777
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN6332 Issued in FL
Legal business name
BOB W. DEASON, DDS, PA
Practice address
765 Mill Creek Rd
Jacksonville, FL 32211-6432
Phone
(904) 724-6321
Fax
(904) 721-6151
NPI assigned
Jan 18, 2010
Last updated
Jan 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Authorized official

Name
Dr. Bob Deason, DDSNPI 1548388135
Title
Owner/President
Phone
(904) 724-6321

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 DN6332 FL Primary

Addresses

Primary practice location

765 Mill Creek Rd
Jacksonville, FL 32211-6432

Mailing address

765 Mill Creek Rd
Jacksonville, FL 32211-6432
Phone (904) 724-6321

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": "1263772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263772800000",
    "number": "1861723777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 MILL CREEK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116432",
            "telephone_number": "904-724-6321",
            "fax_number": "904-721-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 MILL CREEK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116432",
            "telephone_number": "904-724-6321",
            "fax_number": "904-721-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOB W. DEASON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A",
        "authorized_official_last_name": "DEASON",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "904-724-6321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN6332",
            "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 Jan 18, 2010; 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.