NPIMap

Organization Active NPI

Florida Sedation, Implant and Dental Surgery Associates, LLC

Doing business as Dental Specialists of North Florida

  • Periodontics
  • St Augustine, FL
National Provider Identifier
1932623733
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN21628 Issued in FL
Legal business name
FLORIDA SEDATION, IMPLANT AND DENTAL SURGERY ASSOCIATES, LLC
Doing business as
Dental Specialists of North Florida
Practice address
10 Saint Johns Medical Park Dr Ste C
Saint Augustine, FL 32086-5202
Phone
(904) 794-1000
Fax
(904) 794-1004
NPI assigned
Aug 2, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA SEDATION, IMPLANT AND DENTAL SURGERY ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
John W Thousand IV, D.D.S.NPI 1972990752
Title
Owner
Phone
(904) 794-1000

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
Periodontics 1223P0300X DN21628 FL Primary

Addresses

Primary practice location

10 Saint Johns Medical Park Dr Ste C
Saint Augustine, FL 32086-5202

Mailing address

10 Saint Johns Medical Park Dr Ste C
Saint Augustine, FL 32086-5202
Phone (904) 794-1000

Other names 1

  • Dental Specialists of North Florida Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Florida Sedation Implant and Dental Surgery Associates LLC2 organizations share this tax ID, including this one
Part of
Florida Sedation Implant and Dental Surgery Associates LLC

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1932623733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SAINT JOHNS MEDICAL PARK DR STE C",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865202",
            "telephone_number": "904-794-1000",
            "fax_number": "904-794-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SAINT JOHNS MEDICAL PARK DR STE C",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865202",
            "telephone_number": "904-794-1000",
            "fax_number": "904-794-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SEDATION, IMPLANT AND DENTAL SURGERY ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA SEDATION, IMPLANT AND DENTAL SURGERY ASSOCIATES, LLC",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "THOUSAND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-794-1000",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN21628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Specialists of North Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.