NPIMap

Comfortable Care Dental Health Professionals, P.a.

Organization Active NPI General Practice Dentistry · Jacksonville, FL

NPI 1922486943 · NPPES record last updated May 11, 2015

Key facts

NPI
1922486943
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Practice address
10920 Baymeadows Rd Ste 5
Jacksonville, FL 32256-4571
Phone
(904) 363-3559
NPI assigned
May 11, 2015
Organization subpart
Yes
Parent organization (as reported)
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.

Authorized official

Name
Kim Wilson
Title
Cred Supervisor
Phone
(217) 540-5170

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

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

National Provider Directory

Tax ID family
Comfortable Care Denta Health Professionals PA (455 organizations share this tax ID)
Part of
Comfortable Care Denta Health Professionals PA

Locations

10920 Baymeadows Rd
Ste 5
Jacksonville, FL 32256
Phone (904) 363-3559

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP		 1223G0001X Yes

Addresses

Primary practice location

10920 Baymeadows Rd Ste 5
Jacksonville, FL 32256-4571

Mailing address

10920 Baymeadows Rd Ste 5
Jacksonville, FL 32256-4571
Phone (904) 363-3559

Other names

  • Reedy Branch Family Dentistry Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 11, 2015.

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1922486943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 BAYMEADOWS RD STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564571",
            "telephone_number": "904-363-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10920 BAYMEADOWS RD STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564571",
            "telephone_number": "904-363-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reedy Branch Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

All providers in Jacksonville, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.