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General NPI Number Information
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NPI Number | 1538943188
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Entity Type | Individual
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Provider Name | JOHN PERRY NUVEEN DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 3615 DUPONT AVE STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2776
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Country | US
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Telephone | 904-751-1274
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Fax |
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Provider Business Mailing Address
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Address Line | 3650 ENSO WAY APT 6303
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0025
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Country | US
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Telephone | 701-213-0493
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 28560
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License Number State | FL
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