Jacksonville Dentistry Pllc is a renowned Dental office in Jacksonville, Florida. It is located at 12058 San Jose Blvd Ste 102, Jacksonville, FL and its contact number is 904-880-3131. The authorized person for Jacksonville Dentistry Pllc is Peter Kelly
who is Owner of the place and their contact number is 410-410-3031.
Jacksonville Dentistry Pllc Office is a healthcare facility where dedicated dental team composed of licensed professionals, including dentists (DDS or DMD), dental hygienists, dental assistants, and administrative staff (manage appointments, billing, and patient records) provides preventive, diagnostic, and therapeutic oral health services like oral exams and X-rays, fillings, fluoride treatments, teeth cleanings, implants, crowns, bridges, tooth extractions, root canals, and cosmetic procedures such as teeth whitening, braces and veneers to patients through outpatient care.
Complete Profile:
Jacksonville Dentistry Pllc Office speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Jacksonville Dentistry Pllc
Specialization:
Dentistry
Address:
12058 San Jose Blvd Ste 102, Jacksonville, Florida, 32223-8669
Phone:
904-880-3131
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this Office are as below. Person's position and contact details are also mentioned below.
Name:
Peter Kelly
Position:
Owner
Contact Number:
410-410-3031
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Jacksonville Dentistry Pllc Office are as mentioned below.
NPI Number:
1417541079
NPI Enumeration Date:
24 Feb, 2021
NPI Last Update On:
24 Feb, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jacksonville Dentistry Pllc are as mentioned below.
Specialization
License Number
State
Status
Dental
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the Office such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
DN0013386
Other
Florida
State License
DN19430
Other
Florida
State License
DN21484
Other
Florida
State License
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Jacksonville Dentistry Pllc 12058 San Jose Blvd Ste 102, Jacksonville, Florida
Zip:
32223-8669
Phone Number:
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Patients can reach Jacksonville Dentistry Pllc at 12058 San Jose Blvd Ste 102, Jacksonville, Florida or can call to book an appointment on 904-880-3131. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 June, 2025.