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JACKSONVILLE TONGUE TIE LLC
NPI 1831858067
Dentist - Pediatric Dentistry in Saint Johns, FL

Active since December 15, 2021
196 EVEREST LN STE 1, SAINT JOHNS, FL 32259(904) 584-9004 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacksonville Tongue Tie Llc NPPES

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

JACKSONVILLE TONGUE TIE LLC (NPI 1831858067) is a healthcare organization registered as a pediatric dentistry in Saint Johns, Florida and active in the NPI registry since December 2021. The organization maintains a secondary practice location in Yulee and lists Stacey Veal, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1831858067
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameJACKSONVILLE TONGUE TIE LLC
Location Address196 EVEREST LN STE 1Saint Johns, FL 32259-4103
Mailing Address196 Everest Ln Ste 1Saint Johns, FL 32259-4103 · (904) 584-9004 · Fax (904) 347-2011
Phone(904) 584-9004
Organization SubpartNo
Authorized OfficialStacey VealPractice Administrator · (904) 584-9004
Enumeration DateDecember 15, 2021
NPPES CertifiedDecember 15, 2021
✔ NPI 1831858067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
196 EVEREST LN STE 1, Saint Johns, FL 32259
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Secondary Practice Location 1

Location 1463725 State Road 200 Ste 3Yulee, FL 32097-8671 · Phone (904) 849-2400

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

Other Providers at the Same Location NPPES

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

DR. NATALIA MARIA CABALLERO MARRERO DDS
Dentist (Pediatric Dentistry)
196 EVEREST LN STE 1
ST JOHNS, FL 32259
St. Johns County (904) 584-9004

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 Tongue Tie LLC's NPI number?

The NPI number for Jacksonville Tongue Tie LLC is 1831858067. It was assigned to this organization in the NPPES registry on December 15, 2021.

Where is Jacksonville Tongue Tie LLC located?

Jacksonville Tongue Tie LLC is located at 196 Everest Ln Ste 1, Saint Johns, FL 32259. The listed phone number is (904) 584-9004.

What is Jacksonville Tongue Tie LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Jacksonville Tongue Tie LLC was last updated on December 15, 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.