NPIMap

Organization Active NPI

Ronald H Copenhaver DMD PA

Doing business as Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • St Petersburg, FL
National Provider Identifier
1871730317
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6749 Issued in FL
Legal business name
RONALD H COPENHAVER DMD PA
Doing business as
Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery
Practice address
4338 1St Street N
Suite C
St. Petersburg, FL 33703
Phone
(727) 822-2228
Fax
(727) 822-2441
NPI assigned
Jan 20, 2009
Last updated
Jul 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Authorized official

Name
Dr. Ronald H. Copenhaver, D.M.D.,
Title
Owner
Phone
(727) 822-2228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 6749 FL Primary

Addresses

Primary practice location

4338 1St Street N
Suite C
St. Petersburg, FL 33703

Mailing address

4338 1St Street N
Suite C
St. Petersburg, FL 33703
Phone (727) 822-2228

Other names 1

  • Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

4338 1st St N
Ste C
St Petersburg, FL 33703
Phone (727) 822-2228

Practitioners & affiliated clinicians

Practitioners 4

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": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1871730317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4338 1ST STREET N",
            "address_2": "SUITE C",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33703",
            "telephone_number": "727-822-2228",
            "fax_number": "727-822-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4338 1ST STREET N",
            "address_2": "SUITE C",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33703",
            "telephone_number": "727-822-2228",
            "fax_number": "727-822-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD H COPENHAVER DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "COPENHAVER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-822-2228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D.,"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "6749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.