NPIMap

Organization Active NPI

Comfortable Care Dental Health Professionals, PA

Doing business as Arlington River Family Dental

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1972712289
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10849 Issued in FL
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Doing business as
Arlington River Family Dental
Practice address
456 University Blvd N
Jacksonville, FL 32211-6954
Phone
(904) 721-1400
Fax
(904) 726-9972
NPI assigned
May 22, 2007
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Pam Hardiek
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10849 FL Primary

Addresses

Primary practice location

456 University Blvd N
Jacksonville, FL 32211-6954

Mailing address

456 University Blvd N
Jacksonville, FL 32211-6954
Phone (904) 721-1400

Other names 1

  • Arlington River Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfortable Care Dental Health Professionals457 organizations share this tax ID, including this one
Part of
Comfortable Care Dental Health Professionals

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

456 University Blvd N
Jacksonville, FL 32211
Phone (904) 721-1400

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1972712289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116954",
            "telephone_number": "904-721-1400",
            "fax_number": "904-726-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116954",
            "telephone_number": "904-721-1400",
            "fax_number": "904-726-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "HARDIEK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "10849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arlington River Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 19, 2011; 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.