Jeffrey Broughton Ingalls, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN27659 Issued in FL

Practice address

168 14TH St SW Ste B
Largo, FL 33770-6103

Phone

(727) 585-5494

NPI assigned

Aug 16, 2011

Last updated

Feb 3, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Bay Center for Oral & Implant Surgery, P.a.

  dba Bay Center for Oral & Implant Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Largo, FL
  • NPI 1073784872
  NPD (past)
• Ronald H Copenhaver DMD PA

  dba Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • St Petersburg, FL
  • NPI 1871730317
  NPD (past)
• West Ga Oral Surgery Associates, P.C.

  • Oral and Maxillofacial Pathology Dentistry
  • Lagrange, GA
  • NPI 1942403795
  NPD (past)

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1053690453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 14TH ST SW STE B",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337706103",
            "telephone_number": "727-585-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 14TH ST SW STE B",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337706103",
            "telephone_number": "727-585-5494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4338 1st St N Ste C",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337034900",
            "country_code": "US",
            "telephone_number": "727-822-2228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6700 Crosswinds Dr N Ste 100B",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337105474",
            "country_code": "US",
            "telephone_number": "727-821-5375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5590 Roswell Rd Ste H270",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303421909",
            "country_code": "US",
            "telephone_number": "678-365-4889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGALLS",
        "first_name": "JEFFREY",
        "middle_name": "BROUGHTON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN014274",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN27659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Innovative Eyecare, P.a.

• Oral and Maxillofacial Surgery (Dentist) in Largo, FL
• Providers in Largo, 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 Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.