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SOUTHSIDE ASPEN PLLC
NPI 1558947739
Dentist - General Practice in Jacksonville, FL

Active since March 19, 2021
9920 SOUTHSIDE BLVD., JACKSONVILLE, FL 32256(904) 240-3439 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jun 20, 2023, Mar 19, 2021 (2 updates tracked since 2021).

About Southside Aspen Pllc NPPES

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

SOUTHSIDE ASPEN PLLC (NPI 1558947739) is a healthcare organization registered as a general practice in Jacksonville, Florida and active in the NPI registry since March 2021. The organization lists Jong Yun Park, Owner, as its authorized official.

NPPES Registry Identity

NPI1558947739
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHSIDE ASPEN PLLC
Location Address9920 SOUTHSIDE BLVD.Jacksonville, FL 32256
Mailing AddressPo Box 70887Cleveland, OH 44190-0887
Phone(904) 240-3439
Organization SubpartNo
Authorized OfficialJong Yun ParkOwner · (904) 240-3439
Enumeration DateMarch 19, 2021
Last NPPES UpdateJune 20, 20232 updates tracked since enumeration
NPPES CertifiedJune 20, 2023
✔ NPI 1558947739 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.
9920 SOUTHSIDE BLVD., Jacksonville, FL 32256
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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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES

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

VADIM A VANKOV DMD
Dentist (General Practice)
9920 SOUTHSIDE BLVD.
JACKSONVILLE, FL 32256
Duval County (904) 662-6337

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 Southside Aspen PLLC's NPI number?

The NPI number for Southside Aspen PLLC is 1558947739. It was assigned to this organization in the NPPES registry on March 19, 2021.

Where is Southside Aspen PLLC located?

Southside Aspen PLLC is located at 9920 Southside Blvd., Jacksonville, FL 32256. The listed phone number is (904) 240-3439.

What is Southside Aspen PLLC's specialty?

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

What insurance does Southside Aspen PLLC accept?

Health plans from Ambetter Health, Ambetter of Alabama and UnitedHealthcare list Southside Aspen PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southside Aspen PLLC was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.