OrganizationActive
Ideal Dental South Jacksonville PLLC
NPI 1255067179 · Dentist · Jacksonville, FL
Ideal Dental South Jacksonville PLLC is a Dentist organization in Jacksonville, FL (NPI 1255067179).
Provider details
- NPI number
- 1255067179
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Matthew Doan, Owner(972) 331-8079
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5753 Beach Boulevard
Unit #4
Jacksonville, FL 32207
Phone: (904) 441-1642
Fax: (904) 877-3037
Street-level locationGet directions
Mailing address
Po Box 840925
Dallas, TX 75284-0925
Registry dates
- Enumerated
- 2022-07-25
- Last updated
- 2023-10-04
- Certified
- 2023-10-02
Frequently asked questions
- What is Ideal Dental South Jacksonville PLLC's NPI number?
- Ideal Dental South Jacksonville PLLC's National Provider Identifier (NPI) is 1255067179, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ideal Dental South Jacksonville PLLC?
- Ideal Dental South Jacksonville PLLC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Ideal Dental South Jacksonville PLLC located?
- Ideal Dental South Jacksonville PLLC's practice location on file with NPPES is 5753 Beach Boulevard, Jacksonville, FL 32207.
- What is Ideal Dental South Jacksonville PLLC's phone number?
- The practice phone number listed in the NPPES registry for Ideal Dental South Jacksonville PLLC is (904) 441-1642.
- Who is the authorized official for Ideal Dental South Jacksonville PLLC?
- The authorized official listed on Ideal Dental South Jacksonville PLLC's NPPES record is Matthew Doan, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ideal Dental South Jacksonville PLLC's NPI active?
- Yes — Ideal Dental South Jacksonville PLLC's NPI (1255067179) is active in the NPPES registry as of the last update on 2023-10-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.