MEDICARE: AMANDO DENTAL CORPORATION

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	305R00000X	Preferred Provider Organization	DN15716	FL

General Provider Information

NPI Number	:	1275739237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDO DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	3545-1 ST. JOHNS BLUFF RD. S.
Second Line	:	SUITE 352
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224
Country	:	US
Telephone Number	:	904-998-7000
Fax Number	:	904-998-7702

Provider Business Practice Location Address
First Line	:	4540 SOUTHSIDE BLVD
Second Line	:	SUITE 801
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5492
Country	:	US
Telephone Number	:	904-642-2010
Fax Number	:	904-642-8282

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	CRYSTAL L LESS
Credential	:
Telephone Number	:	904-998-7000

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	01/26/2015

Similar Medicare Providers

1093849895 — ADVANCED DENTAL CARE OF JACKSONVILLE PA
Practice Location Address:

4540 SOUTHSIDE BLVD , 1001
JACKSONVILLE, FL
32216-5492

Practice Phone: 904-725-4433
Practice Fax:

1295918548 — DEERWOOD LAKE CHIROPRACTIC
Practice Location Address:

4540 SOUTHSIDE BLVD , STE. # 1101
JACKSONVILLE, FL
32216-5492

Practice Phone: 904-996-8660
Practice Fax: 904-996-8650

1699094151 — DR. BROCK PHILIPS DMD
Practice Location Address:

4540 SOUTHSIDE BLVD , SUITE 801
JACKSONVILLE, FL
32216-5492

Practice Phone: 904-642-2010
Practice Fax: 904-642-8282

1083929905 — MS. STEPHANIE K HUMPHRIES L.M.E.
Practice Location Address:

4540 SOUTHSIDE BLVD , SUITE 701
JACKSONVILLE, FL
32216-5492

Practice Phone: 904-472-5563
Practice Fax: 904-435-4051

1336454263 — TOTAL BODY AESTHETICS, INC.
Practice Location Address:

4540 SOUTHSIDE BLVD , SUITE 701
JACKSONVILLE, FL
32216-5492

Practice Phone: 904-472-5563
Practice Fax: 904-435-4051

1417398835 — MRS. LYNN H POWELL LMHC, CTRS
Practice Location Address:

4540 SOUTHSIDE BLVD , SUITE 401
JACKSONVILLE, FL
32216-5492

Practice Phone: 904-566-9256
Practice Fax: 904-595-5199

Directions to “AMANDO DENTAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.