Oral and Maxillofacial Surgery of Jacksonville, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL AND MAXILLOFACIAL SURGERY OF JACKSONVILLE, PLLC

Doing business as

Jacksonville Surgical Arts Oral and Maxillofacial Surgery

Practice address

95 Jaidev Road
BLDG 10, Suite101
St. Johns, FL 32259-1140

Phone

(904) 820-8956

Fax

(904) 820-8957

NPI assigned

Sep 17, 2026

Last updated

Sep 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vincent Perciaccante

Title

Owner

Phone

(904) 820-8956

Specialties & licenses 1

Addresses

Other names 1

• Jacksonville Surgical Arts Oral and Maxillofacial Surgery Doing business as

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1356253199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 JAIDEV ROAD",
            "address_2": "BLDG 10, SUITE101",
            "city": "ST. JOHNS",
            "state": "FL",
            "postal_code": "322591140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 JAIDEV ROAD",
            "address_2": "BLDG 10, SUITE101",
            "city": "ST. JOHNS",
            "state": "FL",
            "postal_code": "322591140",
            "telephone_number": "904-820-8956",
            "fax_number": "904-820-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGERY OF JACKSONVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "PERCIACCANTE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-820-8956"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Surgical Arts Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Saint Johns, FL
• Providers in Saint Johns, 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 Sep 17, 2026; 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.