904 IMPLANTS AND DENTURES PLLC
NPI 1700549136
Clinic/Center - Dental in Jacksonville, FL

Active since October 21, 2021
11645 BEACH BLVD STE 101, JACKSONVILLE, FL 32246(904) 999-9000 Get Directions Write a Review

NPPES record last updated: October 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 904 Implants And Dentures Pllc NPPES

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

904 IMPLANTS AND DENTURES PLLC (NPI 1700549136) is a healthcare organization registered as a dental in Jacksonville, Florida and active in the NPI registry since October 2021. The organization lists William Russell, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1700549136
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business Name904 IMPLANTS AND DENTURES PLLC
Location Address11645 BEACH BLVD STE 101Jacksonville, FL 32246-8496
Mailing Address11645 Beach Blvd Ste 101Jacksonville, FL 32246-8496 · (904) 999-9000
Organization SubpartNo
Authorized OfficialWilliam RussellCo-owner · (803) 665-6998
Enumeration DateOctober 21, 2021
NPPES CertifiedOctober 21, 2021
NPI 1700549136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
11645 BEACH BLVD STE 101, Jacksonville, FL 32246

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
11645 BEACH BLVD STE 101
JACKSONVILLE, FL 32246

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 904 Implants And Dentures PLLC's NPI number?

The NPI number for 904 Implants And Dentures PLLC is 1700549136. It was assigned to this organization in the NPPES registry on October 21, 2021.

Where is 904 Implants And Dentures PLLC located?

904 Implants And Dentures PLLC is located at 11645 Beach Blvd Ste 101, Jacksonville, FL 32246. The listed phone number is (904) 999-9000.

What is 904 Implants And Dentures PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for 904 Implants And Dentures PLLC was last updated on October 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.