Individual provider Active NPI

Joshua R. Lovelace, DMD

  • General Practice Dentistry
  • Ponte Vedra, FL
National Provider Identifier
1962026393
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN24911 Issued in FL
Practice address
4220 Valley Ridge Blvd Ste 101
Ponte Vedra, FL 32081-5172
Phone
(904) 345-0339
NPI assigned
Jun 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN24911 FL Primary

Addresses

Primary practice location

4220 Valley Ridge Blvd Ste 101
Ponte Vedra, FL 32081-5172

Mailing address

4220 Valley Ridge Blvd Ste 101
Ponte Vedra, FL 32081-5172
Phone (904) 345-0339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN24911FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Family Dentistry, LLC General Practice CurrentSince Oct 16, 2022 Accepting new patients

Locations

4220 Valley Ridge Blvd
Ste 101
Ponte Vedra, FL 32081
Phone (561) 719-4835

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1962026393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 VALLEY RIDGE BLVD STE 101",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815172",
            "telephone_number": "904-345-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 VALLEY RIDGE BLVD STE 101",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815172",
            "telephone_number": "904-345-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "JOSHUA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.