PEDIATRIC SMILES, INC (NPI# 1912014937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912014937 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SMILES, INC |
| Practice Address |
2262 Dunn Ave Ste 4 Jacksonville FL 32218 |
| Mailing Address |
Po Box 26701 Jacksonville FL 32226-6701 |
| Practice Telephone | 9047515126 |
| Practice Fax Number | 9047515146 |
| Mailing Telephone | 9047515126 |
| Mailing Fax Number | 9047515146 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. STACI SUGGS (OWNER/DENTIST) |
| Authorized Official Telephone | 9047515126 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN 15344 | FL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | ADI HEALTHY KIDS | 70084 | 01 |
| Street Address |
2262 DUNN AVE STE 4 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598127151 | Foot Ankle & Wound Care Center Corp | Podiatrist | 2262 Dunn Ave, Suite #3, Jacksonville, FL 32218-4720 | 2016-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558701177 | Richard W Blake Dds Pa | Dentist | 943 Cesery Blvd Ste D, Jacksonville, FL 32211-5655 | 2013-06-27 |
| 1336405315 | Matthew Allen Swan | Dentist | 3714 Heath Rd Fl 32277, Jacksonville, FL 32277-2045 | 2012-04-04 |
| 1215208947 | Culberson R Boren Dds | Dentist | 1634 S Jackson St, Jacksonville, TX 75766-3028 | 2012-01-26 |
| 1871755512 | Barry Philip Setzer | Dentist | 8355 Bayberry Rd, Jacksonville, FL 32256-4427 | 2008-06-25 |
| 1639370216 | Thomas Arch Pribisco | Dentist | 10822 Saint Augustine Rd, Jacksonville, FL 32257-1154 | 2007-05-30 |
| 1932317922 | Jodi Eve Mason | Dentist | 2008 Riverside Ave, Suite 101, Jacksonville, FL 32204-4443 | 2007-05-21 |
| 1679606768 | Marzieh Zahedi | Dentist | 14453 Beach Blvd, Suite 100, Jacksonville, FL 32250 | 2007-03-14 |
| 1780734251 | Jila J Mahajan | Dentist | 4495 Roosevelt Blvd Ste 111, Jacksonville, FL 32210-3382 | 2007-01-10 |
| 1558467498 | Barry P Setzer Dds and Stephen D Cochran Dmd Pa | Dentist | 8355 Bayberry Road, Jacksonville, FL 32256 | 2006-09-16 |
| 1558477414 | Staci Suggs | Dentist | 1651 Southside Connector Blvd., #1, Jacksonville, FL 32225 | 2006-08-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
Please comment or provide details below to improve the information on PEDIATRIC SMILES, 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.