PONTE VEDRA ENDODONTICS NPI 1649820630

NPI Information

  • NPI: 1649820630
  • Provider Name: PONTE VEDRA ENDODONTICS
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Organization
  • Address: 822 A1A NORTH
    STE 314
    PONTE VEDRA BEACH, FL
    ZIP 32082
  • Phone: (904) 273-5770

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NPI Details

PONTE VEDRA ENDODONTICS is an endodontics dentist in Ponte Vedra Beach, FL. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. PONTE VEDRA ENDODONTICS NPI is 1649820630. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

822 A1A NORTH
STE 314
PONTE VEDRA BEACH, FL
ZIP 32082
Phone: (904) 273-5770
Fax: (904) 701-6252

The provider's authorized official is Joseph C Mavec .
The authorized official title is Dds / Owner and has the following contact phone number (904) 273-5770.

The enumeration date for this NPI number is 9/12/2019 and was last updated on 9/12/2019.

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
11223E0200XDentistEndodonticsYes

What is NPI?

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

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