Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JAXOMS, P.A.
NPI 1619893336
Dentist - Oral and Maxillofacial Surgery in Tampa, FL

Q: What is Jaxoms, P.A.'s NPI number?

The NPI number for Jaxoms, P.A. is 1619893336. It was assigned to this organization in the NPPES registry on June 26, 2026. The provider is doing business as Gulf Coast Dental Implants & Oral Surgery.

Q: What is Jaxoms, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Jaxoms, P.A. was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.

Active since June 26, 2026

17425 BRIDGE HILL CT STE 103, TAMPA, FL 33647(402) 805-4516 Get Directions Write a Review

NPPES record added: June 26, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Jaxoms, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAXOMS, P.A. (NPI 1619893336), doing business as Gulf Coast Dental Implants & Oral Surgery, is a healthcare organization registered as an oral and maxillofacial surgery in Tampa, Florida and active in the NPI registry since June 2026. The organization lists Jenn Heritage, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1619893336

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameJAXOMS, P.A.

Location Address17425 BRIDGE HILL CT STE 103Tampa, FL 33647-3657

Mailing Address17425 Bridge Hill Ct Ste 103Tampa, FL 33647-3657

Phone(402) 805-4516

Organization SubpartYes

Authorized OfficialJenn HeritageCredentialing Manager · (402) 805-4516

Enumeration DateJune 26, 2026

NPPES CertifiedJune 26, 2026

✔ NPI 1619893336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

17425 BRIDGE HILL CT STE 103, Tampa, FL 33647

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Other Names 1

Doing Business AsGulf Coast Dental Implants & Oral Surgery

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Jaxoms, P.A.'s NPI number?

The NPI number for Jaxoms, P.A. is 1619893336. It was assigned to this organization in the NPPES registry on June 26, 2026. The provider is doing business as Gulf Coast Dental Implants & Oral Surgery.

Where is Jaxoms, P.A. located?

Jaxoms, P.A. is located at 17425 Bridge Hill Ct Ste 103, Tampa, FL 33647. The listed phone number is (402) 805-4516.

What is Jaxoms, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Jaxoms, P.A. was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.