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

Jacksonville Dental Specialists

Organization Periodontics · NPI 1568915387

Jacksonville Dental Specialists is a Periodontics in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2016.

Licensed in
FL
In the registry since
2016
Specialties on file
2

Practice location Address checks out

11512 Lake Mead Ave Ste 532
Jacksonville, FL 32256-9680
Phone: (904) 460-4201
Fax: (904) 683-3914
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthodontics (primary) Taxonomy 1223P0700X · Licence DN18280 (FL)
Periodontics Taxonomy 1223P0300X · Licence DN16648 (FL)

Record details

NPI number1568915387
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationJacksonville Dental Specialists
Authorized official Lydia Cuevas — Practice Coordinator · (904) 683-4781
NPI enumeratedJuly 28, 2016
Last updated in NPPESJuly 28, 2016
Mailing address11512 Lake Mead Ave, Ste. 532, Jacksonville, FL 32256-9680

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