| Mandarin South Dentistry Pa | |
|
12421 San Jose Blvd Ste 2a Jacksonville FL 32223-8663 | |
| (904) 268-7552 | |
| (904) 268-9792 |
| Full Name | Mandarin South Dentistry Pa |
|---|---|
| Speciality | Dentist |
| Location | 12421 San Jose Blvd Ste 2a, Jacksonville, Florida |
| Authorized Official Name and Position | Nanjappa Shivashanakr (PRESIDENT) |
| Authorized Official Contact | 9042687552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mandarin South Dentistry Pa 12421 San Jose Blvd Ste 2a Jacksonville FL 32223-8663 Ph: (904) 268-7552 | Mandarin South Dentistry Pa 12421 San Jose Blvd Ste 2a Jacksonville FL 32223-8663 Ph: (904) 268-7552 |
| NPI Number | 1699218800 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 11/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699218800 | NPI | - | NPPES |
| 12 | Other | FL | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN9317 (Florida) | Primary |
Donald L. Smitha, Dds, Mds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 812 Alderman Rd, Jacksonville, FL 32211 Phone: 904-725-8282 Fax: 904-725-7197 | |
Selena L Marchan, Dmd, Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 13475 Atlantic Blvd, Ste 36, Jacksonville, FL 32225 Phone: 904-246-2603 Fax: 904-247-9663 | |
Roger D. Robinson Jr., D.m.d., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3595 Cardinal Point Drive, Jacksonville, FL 32257 Phone: 904-737-2040 Fax: 904-737-2051 | |
Aspen Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8440 Blanding Blvd, Jacksonville, FL 32244 Phone: 904-525-8041 Fax: 315-410-5531 | |
Ben Lewis, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 N Lee St, Jacksonville, FL 32204 Phone: 904-366-3736 | |
Joseph G Chiafair Dds Ms Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9471 Baymeadows Rd, Suite 101, Jacksonville, FL 32256 Phone: 904-739-3939 Fax: 904-739-1381 | |
Timothy J Parker Dmd Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 8351 Bayberry Rd, Jacksonville, FL 32256 Phone: 904-737-3263 Fax: 904-448-5301 |