Provider Demographics
NPI:1225678436
Name:ADVN DENTAL PARTNERS PA
Entity Type:Organization
Organization Name:ADVN DENTAL PARTNERS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD - DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:NERIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:904-553-4859
Mailing Address - Street 1:175 NW 138TH TERRACE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JONESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32669
Mailing Address - Country:US
Mailing Address - Phone:352-332-3080
Mailing Address - Fax:352-333-3729
Practice Address - Street 1:2460 N ESSEX AVENUE
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442
Practice Address - Country:US
Practice Address - Phone:352-527-1614
Practice Address - Fax:352-527-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty