OrganizationActive
Mandarin South Dentistry PA
NPI 1699218800 · Dentist · Jacksonville, FL
Provider details
- NPI number
- 1699218800
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Nanjappa Shivashanakr, President(904) 268-7552
- License
- DN9317 (FL)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12421 San Jose Blvd Ste 2a
Jacksonville, FL 32223-8663
Phone: (904) 268-7552
Fax: (904) 268-9792
Street-level locationGet directions
Mailing address
12421 San Jose Blvd Ste 2a
Jacksonville, FL 32223-8663
Registry dates
- Enumerated
- 2016-11-21
- Last updated
- 2016-11-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.