MARIETTA DENTAL GROUP (NPI# 1679972665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679972665 |
| Entity Type | Organization |
| Organization Name | MARIETTA DENTAL GROUP |
| Practice Address |
8209 W. Beaver St. Suite 100 Jacksonville FL 32220 |
| Mailing Address |
3545-1 St. Johns Bluff Rd. S. Suite 352 Jacksonville FL 32224 |
| Practice Telephone | 9049987000 |
| Practice Fax Number | 9049987702 |
| Mailing Telephone | 9049987000 |
| Mailing Fax Number | 9049987702 |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2015-01-26 |
| Authorized Official Name | CRYSTAL L LESS (VP OF OPERATIONS) |
| Authorized Official Telephone | 9049987000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN15716 | FL | Dental Providers |
| Street Address |
8209 W. BEAVER ST. SUITE 100 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689631962 | Nicholas A Narducci | Dentist | 8209 W. Beaver Street, Suite 100, Jacksonville, FL 32220 | 2006-04-28 |
| 1649267857 | Kci Usa, Inc. | Durable Medical Equipment & Medical Supplies | 7029 Commonwealth Ave., Suite 2, Jacksonville, FL 32220 | 2005-10-03 |
| 1710356332 | Heavenly Angels Homemaker & Companion Services | In Home Supportive Care | 9695 Watershed Dr S, Jacksonville, FL 32220-0903 | 2015-09-24 |
| 1487138798 | Tiffany Mosley | Counselor | 9616 Watershed Dr E, Jacksonville, FL 32220-0905 | 2018-09-21 |
| 1861976003 | Earthly Stars, LLC | Home Health | 9616 Watershed Dr E, Jacksonville, FL 32220-0905 | 2018-09-24 |
| 1659848539 | Shanthalitta Seals Wallace | Counselor | 9617 Watershed Dr E, Jacksonville, FL 32220-0906 | 2018-10-29 |
| 1447306246 | Cynthia Jean Paulk | Speech-Language Pathologist | 9826 Watershed Dr W, Jacksonville, FL 32220-0911 | 2007-01-25 |
| 1497809644 | Tzipora S Johnson | Registered Nurse | 10278 Wellhouse Ct, Jacksonville, FL 32220-1351 | 2007-01-23 |
| 1528489002 | Connie Clark | Counselor | 620 Wellhouse Dr, Jacksonville, FL 32220-1367 | 2013-12-30 |
| 1699277699 | Rgh Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 12075 Pritchard Rd, Jacksonville, FL 32220-1777 | 2018-03-06 |
| Find all providers in zip 32220 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962018424 | Sydney Fowler | Dentist | 12276 San Jose Blvd Ste 314, Jacksonville, FL 32223-8632 | 2020-09-21 |
| 1871106260 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 4445 Town Center Pkwy, Jacksonville, FL 32246-8565 | 2020-08-26 |
| 1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1659923118 | San Jose Aspen Pllc | Dentist | 10502 San Jose Blvd Ste B, Jacksonville, FL 32257-6209 | 2019-07-15 |
| 1326603176 | Evens Family Dental | Dentist | 13107 Atlantic Blvd, Jacksonville, FL 32225-7127 | 2019-05-07 |
| 1487123006 | Susan Prater Kudlats, D.m.d, P.a. | Dentist | 12620 Beach Blvd Ste 18, Jacksonville, FL 32246-7130 | 2018-11-14 |
| 1043792534 | Atlantic Dentistry Pa | Dentist | 13474 Atlantic Blvd Ste 109, Jacksonville, FL 32225-0100 | 2018-08-31 |
| 1447738620 | Argyle Dental Pllc | Dentist | 6001 Argyle Forest Blvd Ste 4, Jacksonville, FL 32244-6127 | 2018-07-31 |
| 1427534445 | Sandeep Chunduru | Dentist | 571 Yopp Rd Ste 308, Jacksonville, NC 28540-3683 | 2018-07-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32220 |
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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.