JACKSONVILLE FAMILY DENTISTRY AT SOUTHSIDE, INC (NPI# 1073024006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073024006 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE FAMILY DENTISTRY AT SOUTHSIDE, INC |
| Practice Address |
8101 Southside Blvd Ste 8 Jacksonville FL 32256-8005 |
| Mailing Address |
100 Fairway Park Blvd Unit 512 Ponte Vedra Beach FL 32082-2667 |
| Practice Telephone | 9046412655 |
| Mailing Telephone | 9042105348 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-17 |
| Authorized Official Name | DR. BRYAN KEITH BLANKENSHIP (PRESIDENT) |
| Authorized Official Telephone | 9042105348 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
16941 | FL | Ambulatory Health Care Facilities |
| Street Address |
8101 SOUTHSIDE BLVD STE 8 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-8005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1285242941 | Neil K Stevenson Dmd, Pllc | Clinic/Center | 12078 San Jose Blvd Ste 1, Jacksonville, FL 32223-8671 | 2020-07-20 |
| 1699306803 | Gina Collins Mancini, Dmd | Clinic/Center | 3685 Henderson Dr, Jacksonville, NC 28546-5218 | 2020-01-28 |
| 1598305823 | Lenz Dental, Pllc | Clinic/Center | 13050 Gran Bay Pkwy Unit 1445, Jacksonville, FL 32258-4542 | 2020-01-15 |
| 1265070916 | Allcare Dentistry P.a. | Clinic/Center | 11915 Beach Blvd Ste 115, Jacksonville, FL 32246-6707 | 2019-12-12 |
| 1922641083 | Mariam Barikbin, Dmd, Pa | Clinic/Center | 4114 Herschel St Ste 106, Jacksonville, FL 32210-2200 | 2019-10-22 |
| 1821509340 | River Oaks Dental | Clinic/Center | 6120 San Jose Blvd, Jacksonville, FL 32217-2333 | 2017-10-24 |
| 1083136881 | Samir K. Hanna & Associates, P.a. | Clinic/Center | 5435 Ortega Blvd Ste 1, Jacksonville, FL 32210-8435 | 2017-07-13 |
| 1376964353 | Sorrento Dental | Clinic/Center | 106 Julington Plaza Dr, Suite 6, Jacksonville, FL 32259-6217 | 2013-12-18 |
| 1124364971 | Economy Dentistry Dupont Station | Clinic/Center | 3615 Dupont Ave, 200-400, Jacksonville, FL 32217-2790 | 2012-12-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
Please comment or provide details below to improve the information on JACKSONVILLE FAMILY DENTISTRY AT SOUTHSIDE, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.