DR. BETHANY ANN DOUGLAS (NPI# 1437484128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437484128 |
| Entity Type | Individual |
| Full Name | DR. BETHANY ANN DOUGLAS |
| Credential | D.M.D. |
| Practice Address |
1414 Kingsley Ave Suite 1 Orange Park FL 32073-4591 |
| Mailing Address |
6371 Autumn Berry Cir Jacksonville FL 32258-8416 |
| Practice Telephone | 9042694201 |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2012-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
DN014001 | GA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DN19093 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629349824 | Bethany Ann Douglas | Counselor | 2577 Ne Courtney Dr, Bend, OR 97701-7638 | 2012-01-19 |
| Street Address |
1414 KINGSLEY AVE SUITE 1 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669453759 | Gregory A Archambault | Dentist | 1414 Kingsley Ave, Orange Park, FL 32073-4591 | 2005-11-07 |
| 1699918037 | Thomas Allen Brown Jr. | Dentist | 1414 Kingsley Ave, Suite 1, Orange Park, FL 32073 | 2009-04-15 |
| 1538274469 | William B. Nipper, Jr., D.m.d., P.a. | Dentist | 1414 Kingsley Ave, Suite 1, Orange Park, FL 32073-4591 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497307987 | Bradley Sleeth | Dentist | 942 Goldridge Ct, Orange Park, FL 32065-6259 | 2019-07-15 |
| 1518143775 | Jose Luis Marcos-arenal | Dentist | 1562 Wells Rd Ste 16, Orange Park, FL 32073-1723 | 2008-01-17 |
| 1578618542 | Jack Parker Campbell | Dentist | 1700 Wells Rd Ste 19, Orange Park, FL 32073-2374 | 2007-01-23 |
| 1164879052 | Smith Endodontics | Dentist | 1520 Business Center Dr, Suite 2, Orange Park, FL 32003-9011 | 2016-05-20 |
| 1285764860 | Michael R Smith | Dentist | 1530 Business Center Dr, Suite #1, Orange Park, FL 32003-9026 | 2007-03-06 |
| 1538274469 | William B. Nipper, Jr., D.m.d., P.a. | Dentist | 1414 Kingsley Ave, Suite 1, Orange Park, FL 32073-4591 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608736 | Mid-florida Endodontics - Winter Garden Pa | Dentist | 15815 Shaddock Drive, Unit-3, Winter Garden, FL 34787 | 2020-10-30 |
| 1154935799 | Orbit Dental Management Pa | Dentist | 1453 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-1968 | 2020-09-01 |
| 1790397370 | Bruce D. Schulman, Dds Pa | Dentist | 10150 Hagen Ranch Rd Ste 200, Boynton Beach, FL 33437-3776 | 2020-08-17 |
| 1770117525 | Volusia Endodontics Pa | Dentist | 2751 Enterprise Rd Ste 211, Orange City, FL 32763-8262 | 2020-03-02 |
| 1417587130 | Advanced Endodontics of Winter Park, Pa | Dentist | 400 W Morse Blvd Ste 102, Winter Park, FL 32789-4259 | 2020-01-22 |
| 1699326603 | North Central Florida Endodontics,pllc | Dentist | 48 Se 16th Ave, Ocala, FL 34471-2521 | 2019-09-23 |
| 1396395919 | Stephen L. Goldfaden, Dds,pa | Dentist | 1905 Nw 13th St Ste 2, Gainesville, FL 32609-3414 | 2019-09-16 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1437707197 | John Zachary Reynolds | Dentist | 3180 Redeemer Way, New Port Richey, FL 34655-4245 | 2019-08-27 |
| 1134781610 | Annika Marschall Dmd Pa | Dentist | 2425 Presidential Way Apt 1805, West Palm Beach, FL 33401-1321 | 2019-07-03 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
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| 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.