Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

904 Implants and Dentures PLLC

Organization Dental Clinic/Center · NPI 1700549136

904 Implants and Dentures PLLC is a Dental Clinic/Center in Jacksonville, Florida. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11645 Beach Blvd Ste 101
Jacksonville, FL 32246-8496
Phone: (904) 999-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1700549136
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Russell — Co-Owner · (803) 665-6998
NPI enumeratedOctober 21, 2021
Last updated in NPPESOctober 21, 2021
Certification dateOctober 21, 2021
Mailing address11645 Beach Blvd Ste 101, Jacksonville, FL 32246-8496

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