NPIMap

Organization Active NPI

Jacksonville Florida North, PLLC

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1982414066
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JACKSONVILLE FLORIDA NORTH, PLLC
Practice address
651 Nautica Dr Unit 1
Jacksonville, FL 32218-7222
Phone
(904) 423-4014
NPI assigned
Jan 10, 2025
Last updated
Jan 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Kia Williams
Title
Provider Enrollment Team Lead
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

651 Nautica Dr Unit 1
Jacksonville, FL 32218-7222

Mailing address

PO Box 70887
Cleveland, OH 44190-0887

Other practice location 1

4520 Town Center Pkwy Unit 103
Jacksonville, FL 32246-8590
Phone (904) 580-7861

National Provider Directory

National Provider Directory

Locations

4520 Town Center Pkwy
Unit 103
Jacksonville, FL 32246
Phone (904) 580-7861

651 Nautica Dr
#1
Jacksonville, FL 32218
Phone (904) 423-4014

Practitioners & affiliated clinicians

Practitioners 10

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": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1982414066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 NAUTICA DR UNIT 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187222",
            "telephone_number": "904-423-4014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4520 Town Center Pkwy Unit 103",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322468590",
            "country_code": "US",
            "telephone_number": "904-580-7861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSONVILLE FLORIDA NORTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT TEAM LEAD",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "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 Jan 10, 2025; 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.