Jacksonville Dentistry PLLC
NPI 1417541079 · Dental Clinic/Center · Jacksonville, FL
Jacksonville Dentistry PLLC is a Dental Clinic/Center organization in Jacksonville, FL (NPI 1417541079).
Provider details
- NPI number
- 1417541079
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Peter Kelly, Owner(410) 410-3031
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
Mailing address
Registry dates
- Enumerated
- 2021-02-24
- Last updated
- 2021-02-24
- Certified
- 2021-02-24
Frequently asked questions
- What is Jacksonville Dentistry PLLC's NPI number?
- Jacksonville Dentistry PLLC's National Provider Identifier (NPI) is 1417541079, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jacksonville Dentistry PLLC?
- Jacksonville Dentistry PLLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Jacksonville Dentistry PLLC located?
- Jacksonville Dentistry PLLC's practice location on file with NPPES is 12058 San Jose Blvd Ste 102, Jacksonville, FL 32223-8669.
- What is Jacksonville Dentistry PLLC's phone number?
- The practice phone number listed in the NPPES registry for Jacksonville Dentistry PLLC is (904) 880-3131.
- Who is the authorized official for Jacksonville Dentistry PLLC?
- The authorized official listed on Jacksonville Dentistry PLLC's NPPES record is Peter Kelly, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jacksonville Dentistry PLLC's NPI active?
- Yes — Jacksonville Dentistry PLLC's NPI (1417541079) is active in the NPPES registry as of the last update on 2021-02-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.