NPIMap

Organization Active NPI

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

  • Oral and Maxillofacial Surgery (Dentist)
  • Largo, FL
National Provider Identifier
1073784872
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11822 Issued in FL
Legal business name
BAY CENTER FOR ORAL & IMPLANT SURGERY, P.A.
Practice address
168 14TH St SW
Suite B
Largo, FL 33770-6103
Phone
(727) 585-5494
Fax
(727) 584-1820
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Jesse Jakubowski, DMDNPI 1467708230
Title
Owner
Phone
(727) 585-5494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 11822 FL Primary

Addresses

Primary practice location

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

Mailing address

168 14TH St SW
Suite B
Largo, FL 33770-6103
Phone (727) 585-5494

Other practice location 1

6700 Crosswinds Dr N Ste 100B
St Petersburg, FL 33710-5474
Phone (727) 821-5375

Other practice location 2

4338 1st St N Ste C
St Petersburg, FL 33703-4900
Phone (727) 822-2228

Other names 1

  • Bay Center for Oral & Implant Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

168 14th St SW
Ste B
Largo, FL 33770
Phone (727) 585-5494

168 14th St SW
Ste 100B
Largo, FL 33770

6700 Crosswinds Dr N
Ste 100B
St Petersburg, FL 33710
Phone (727) 821-5375

6700 Crosswinds Dr N
St Petersburg, FL 33710
Phone (727) 344-4651

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1073784872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 14TH ST SW",
            "address_2": "SUITE B",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337706103",
            "telephone_number": "727-585-5494",
            "fax_number": "727-584-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 14TH ST SW",
            "address_2": "SUITE B",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337706103",
            "telephone_number": "727-585-5494",
            "fax_number": "727-584-1820"
        }
    ],
    "practiceLocations": [
        {
            "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": "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"
        }
    ],
    "basic": {
        "organization_name": "BAY CENTER FOR ORAL & IMPLANT SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "JAKUBOWSKI",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-585-5494",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "11822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Center for Oral & Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.