Healthcare Provider Details

I. General information

NPI: 1841875259
Provider Name (Legal Business Name): SHAVONE RHODEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-8594
US

IV. Provider business mailing address

8831 HARPERS GLEN CT
JACKSONVILLE FL
32256-4544
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6910
  • Fax: 352-273-5717
Mailing address:
  • Phone: 904-333-3881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN27327
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: