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

St Augustine Oral & Facial Surgical Center PA

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1629288824

St Augustine Oral & Facial Surgical Center PA is an Oral and Maxillofacial Surgery (Dentist) in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
Specialties on file
3
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

1301 Plantation Island Dr S Ste 101
St Augustine, FL 32080-3108
Phone: (904) 460-0505
Fax: (904) 460-0506
Show map & directions

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

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence DN15568 (FL)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence DN15568 (FL)
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician Taxonomy 2082S0099X · Licence DN15568 (FL)

Record details

NPI number1629288824
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Douglas Johnson — Owner · (904) 460-0505
NPI enumeratedMay 23, 2007
Last updated in NPPESJune 23, 2008
Mailing addressPo Box 7870, Springdale, AR 72766-7870

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