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

Jaxoms, PA

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1619893336

Jaxoms, PA is an Oral and Maxillofacial Surgery (Dentist) in Tampa, Florida. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17425 Bridge Hill Ct Ste 103
Tampa, FL 33647-3657
Phone: (402) 805-4516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1619893336
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationJaxoms, PA
Authorized official Jenn Heritage — Credentialing Manager · (402) 805-4516
Other names Gulf Coast Dental Implants & Oral Surgery
NPI enumeratedJune 26, 2026
Last updated in NPPESJune 26, 2026
Certification dateJune 26, 2026
Mailing address17425 Bridge Hill Ct Ste 103, Tampa, FL 33647-3657

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