Jon Windom, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN14686 Issued in FL

Practice address

1081 A1A Beach Blvd
St Augustine, FL 32080-6733

Phone

(904) 471-3291

NPI assigned

May 16, 2007

Last updated

Sep 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Practice roles

Networks

• Freedom Health HMO Network

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.

• Coast Dental P.a.

  dba Coast Dental-Anastasia Island

  • Dentist
  • St Augustine, FL
  • NPI 1821664178
  NPD (past)
• Coast Dental P.a.

  • Dentist
  • Tampa, FL
  • NPI 1992803860
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1205043809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HERITAGE CIR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744208",
            "telephone_number": "386-673-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 A1A BEACH BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806733",
            "telephone_number": "904-471-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDOM",
        "first_name": "JON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Wilson
• Terrence James Wilson, MD, MPH
• Uliana Wilson
• Brooke Alison Wimberley, DNP, FNP-BC
• Phillip Alex Wimpelberg, PA
• Wings of Hope Therapy Center LLC
• Wings of Hope Therapy Center LLC
• Nicole Winkels, APRN
• Jorjiana Winston
• Janet Wiseman, LMHC

• General Practice Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.