DENTAL SUMMIT PLLC NPI 1588172571

NPI Information

  • NPI: 1588172571
  • Provider Name: DENTAL SUMMIT PLLC
  • Classification: Dentist - 1223P0700X
  • Specialization: Prosthodontics
  • Entity Type: Organization
  • Doing Business As: BEACHES DENTISTRY AND WELLNESS
  • Address: 324 3RD AVE N
    JACKSONVILLE BEACH, FL
    ZIP 32250
  • Phone: (904) 246-6714

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NPI Details

DENTAL SUMMIT PLLC is a prosthodontics dentist in Jacksonville Beach, FL. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DENTAL SUMMIT PLLC NPI is 1588172571. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Beaches Dentistry And Wellness.

The provider's business location address is:

324 3RD AVE N
JACKSONVILLE BEACH, FL
ZIP 32250-602
Phone: (904) 246-6714

The provider's authorized official is Nodesh Bangalore Shyamsunder .
The authorized official title is President and has the following contact phone number (904) 246-6714.

The enumeration date for this NPI number is 1/12/2018 and was last updated on 1/12/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0700XDentistProsthodonticsDN20907FLORIDAYes

What is NPI?

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This page was last updated on: 11/21/2025

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