John Frederick Landis, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN 21096 Issued in FL

Practice address

472 Jacksonville Dr
Jacksonville Beach, FL 32250-3812

Phone

(904) 246-6545

Fax

(904) 246-3718

NPI assigned

Apr 11, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaches Oral Maxillofacial Surgery, PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Jacksonville Beach, FL
  • NPI 1265292346
  NPD Authorized official
• John Landis DDS, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Jacksonville Beach, FL
  • NPI 1447720651
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043453723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503812",
            "telephone_number": "904-246-6545",
            "fax_number": "904-246-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503812",
            "telephone_number": "904-246-6545",
            "fax_number": "904-246-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "JOHN",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23434",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 21096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• May Ruth Berryhill Lambert, WHNP
• Emma Lamonica
• Charles Steven Lancaster, O.D.
• Steven J. Lancaster, M.D.
• Jennifer Goodman Land, M.S.
• Rachel Landry, PT
• Simone Lapidus, M.D.
• Megan Leilani Larson
• Ingrid Laurinaitis, P.A.-C
• John Gasper Lazzara, D.D.S.

• Oral and Maxillofacial Surgery (Dentist) in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.