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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACKSONVILLE ORAL SURGERY PLLC
NPI 1871123984
Dentist - Oral and Maxillofacial Surgery in Jacksonville, FL

Active since January 17, 2020
2047 PARK ST, JACKSONVILLE, FL 32204(904) 388-7665 Get Directions Write a Review

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

Record update history: Jul 21, 2026, Jan 17, 2020 (2 updates tracked since 2020).

About Jacksonville Oral Surgery Pllc NPPES

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

JACKSONVILLE ORAL SURGERY PLLC (NPI 1871123984) is a healthcare organization registered as an oral and maxillofacial surgery in Jacksonville, Florida and active in the NPI registry since January 2020. The organization maintains 2 additional practice locations and lists Victoria Johnson, Cro, as its authorized official.

NPPES Registry Identity

NPI1871123984
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameJACKSONVILLE ORAL SURGERY PLLC
Location Address2047 PARK STJacksonville, FL 32204-3809
Mailing Address2047 Park StJacksonville, FL 32204-3809 · (904) 388-7665
Phone(904) 388-7665
Organization SubpartNo
Authorized OfficialVictoria JohnsonCro · (941) 444-0558
Enumeration DateJanuary 17, 2020
Last NPPES UpdateJuly 21, 20262 updates tracked since enumeration
NPPES CertifiedJuly 21, 2026
✔ NPI 1871123984 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.
2047 PARK ST, Jacksonville, FL 32204
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Secondary Practice Locations 2

Location 14232 Baymeadows RdJacksonville, FL 32217-4604 · Phone (904) 739-0690
Location 21409 Kingsley Ave Ste 5Orange Park, FL 32073-4561 · Phone (904) 264-7383

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Solstice Benefits, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 3

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

IMRAY & GESEK DMD PA
Dentist
2047 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 388-7665
DR. DANIEL JAMES GESEK JR. DMD
Dentist (Oral and Maxillofacial Surgery)
2047 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 388-7665
CHRISTOPHER WRIGHT LATHAM DMD
Oral & Maxillofacial Surgery
2047 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 388-7665

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 Oral Surgery PLLC's NPI number?

The NPI number for Jacksonville Oral Surgery PLLC is 1871123984. It was assigned to this organization in the NPPES registry on January 17, 2020.

Where is Jacksonville Oral Surgery PLLC located?

Jacksonville Oral Surgery PLLC is located at 2047 Park St, Jacksonville, FL 32204. The listed phone number is (904) 388-7665.

What is Jacksonville Oral Surgery PLLC's specialty?

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

What insurance does Jacksonville Oral Surgery PLLC accept?

Health plans from Solstice Benefits and UnitedHealthcare list Jacksonville Oral Surgery 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 Oral Surgery PLLC was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.