Organization Active NPI

Quinton Pooler DDS PLLC

  • Dental Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1902622665
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
QUINTON POOLER DDS PLLC
Practice address
12708 San Jose Blvd Ste 3
Jacksonville, FL 32223-2600
Phone
(904) 268-0904
NPI assigned
Nov 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Dr. Quinton Pooler, DDSNPI 1336884212
Title
Owner
Phone
(904) 654-2728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

12708 San Jose Blvd Ste 3
Jacksonville, FL 32223-2600

Mailing address

12708 San Jose Blvd Ste 3
Jacksonville, FL 32223-2600
Phone (904) 268-0904

National Provider Directory

National Provider Directory

Locations

12708 San Jose Blvd
Ste 3
Jacksonville, FL 32223
Phone (904) 268-0904

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1902622665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12708 SAN JOSE BLVD STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232600",
            "telephone_number": "904-268-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12708 SAN JOSE BLVD STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232600",
            "telephone_number": "904-268-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINTON POOLER DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "POOLER",
        "authorized_official_first_name": "QUINTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-654-2728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "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 Nov 26, 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.