PONTE VEDRA COSMETIC DENTISTRY, PA
NPI 1396000329
Dentist - General Practice in Ponte Vedra Beach, FL

Q: What is Ponte Vedra Cosmetic Dentistry, PA's NPI number?

The NPI number for Ponte Vedra Cosmetic Dentistry, PA is 1396000329. It was assigned to this organization in the NPPES registry on July 5, 2012.

Q: What is Ponte Vedra Cosmetic Dentistry, PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since July 05, 2012

100 PROFESSIONAL DR, PONTE VEDRA BEACH, FL 32082(904) 285-8407(904) 285-5346 Get Directions Write a Review

NPPES record last updated: July 5, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ponte Vedra Cosmetic Dentistry, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PONTE VEDRA COSMETIC DENTISTRY, PA (NPI 1396000329) is a healthcare organization registered as a general practice in Ponte Vedra Beach, Florida and active in the NPI registry since July 2012. The organization lists Kamala Rudolph, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1396000329

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NamePONTE VEDRA COSMETIC DENTISTRY, PA

Location Address100 PROFESSIONAL DRPonte Vedra Beach, FL 32082-6216

Mailing Address100 Professional DrPonte Vedra Beach, FL 32082-6216 · (904) 285-8407 · Fax (904) 285-5346

Phone(904) 285-8407

Fax(904) 285-5346

Organization SubpartNo

Authorized OfficialKamala RudolphPractice Administrator · (904) 285-8407

Enumeration DateJuly 5, 2012

✔ NPI 1396000329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

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.

100 PROFESSIONAL DR, Ponte Vedra Beach, FL 32082

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WEST COAST DENTAL PARTNERS

Dentist (General Practice)

100 PROFESSIONAL DR
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 285-8407

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ponte Vedra Cosmetic Dentistry, PA's NPI number?

The NPI number for Ponte Vedra Cosmetic Dentistry, PA is 1396000329. It was assigned to this organization in the NPPES registry on July 5, 2012.

Where is Ponte Vedra Cosmetic Dentistry, PA located?

Ponte Vedra Cosmetic Dentistry, PA is located at 100 Professional Dr, Ponte Vedra Beach, FL 32082. The listed phone number is (904) 285-8407.

What is Ponte Vedra Cosmetic Dentistry, PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Ponte Vedra Cosmetic Dentistry, PA was last updated on July 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.