MEDICARE: DENTAL SLEEP MEDICINE OF NORTHEAST FLORIDA, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1245009166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL SLEEP MEDICINE OF NORTHEAST FLORIDA, PLLC

Provider Business Mailing Address
First Line	:	3676 CROWN POINT CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5966
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3676 CROWN POINT CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5966
Country	:	US
Telephone Number	:	904-780-9462
Fax Number	:

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	CATHERINE CHIAFAIR
Credential	:	DMD
Telephone Number	:	904-780-9462

Provider Enumeration Date	:	12/20/2023
Last Update Date	:	03/17/2026

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