Active NPI
Sushma Chaudhari
- Dentist
- Jacksonville, FL
National Provider Identifier
1982273496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 26048
- Practice address
- 2845 University Blvd W
Jacksonville, FL 32217-2116 - Phone
- (904) 569-6131
- NPI assigned
- Jun 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 26048 | FL | Primary |
Addresses
Primary practice location
2845 University Blvd W
Jacksonville, FL 32217-2116
Mailing address
1001 Pineview Cir SW
Live Oak, FL 32064-3922
Phone (813) 468-9784
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26048 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1982273496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 PINEVIEW CIR SW",
"city": "LIVE OAK",
"state": "FL",
"postal_code": "320643922",
"telephone_number": "813-468-9784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 UNIVERSITY BLVD W",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322172116",
"telephone_number": "904-569-6131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAUDHARI",
"first_name": "SUSHMA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-19",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "FL",
"license": "26048",
"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 Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.