JACKSONVILLE DENTISTRY PLLC
NPI 1417541079
Clinic/Center - Dental in Jacksonville, FL
About Jacksonville Dentistry Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSONVILLE DENTISTRY PLLC (NPI 1417541079) is a healthcare organization registered as a dental in Jacksonville, Florida and active in the NPI registry since February 2021. The organization lists Peter Kelly, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacksonville Dentistry PLLC's NPI number?
The NPI number for Jacksonville Dentistry PLLC is 1417541079. It was assigned to this organization in the NPPES registry on February 24, 2021.
Where is Jacksonville Dentistry PLLC located?
Jacksonville Dentistry PLLC is located at 12058 San Jose Blvd Ste 102, Jacksonville, FL 32223. The listed phone number is (904) 880-3131.
What is Jacksonville Dentistry PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.
What insurance does Jacksonville Dentistry PLLC accept?
Health plans from Ambetter Health, Ambetter of Alabama and UnitedHealthcare list Jacksonville Dentistry PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacksonville Dentistry PLLC was last updated on February 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacksonville Dentistry Pllc · NPI 1417541079
Dental organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since February 24, 2021.
## Identity
- **NPI:** 1417541079 (Entity type: Organization)
- **Enumerated:** February 24, 2021
- **Primary specialty:** Clinic/Center - Dental · taxonomy 261QD0000X
- **Organization subpart:** No
- **Authorized official:** Peter Kelly, OWNER
## Practice location
- **Address:** 12058 SAN JOSE BLVD STE 102, Jacksonville, FL 32223-8669
- **Phone:** (904) 880-3131
## Record status
- **NPPES last updated:** February 24, 2021
- **Other identifiers:** Other DN19430 (FL); Other DN0013386 (FL); Other DN21484 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1417541079) · Data from the CMS NPPES public registry.