First Coast Oral & Facial Surgery, PA

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

FIRST COAST ORAL & FACIAL SURGERY, PA

Practice address

319 W Town Place
Suite 2
St Augustine, FL 32092

Phone

(904) 529-8889

NPI assigned

May 24, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Thomas E Stakem, D.D.S., M.D.

Title

President

Phone

(904) 529-8889

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Charles D Milton Jr., D.D.S., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Yulee, FL
  • NPI 1811107253
  NPD (past)

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1356601249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 WEST TOWN PLACE #2",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-529-8889",
            "fax_number": "904-529-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W TOWN PLACE",
            "address_2": "SUITE 2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-529-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST ORAL & FACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "STAKEM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-529-8889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Heart and Vascular at Flagler Health Inc.
• First Coast Integrative Psychiatry
• First Coast Medical & Dental Supply, LLC
• First Coast Mobile Audiology, LLC
• First Coast Mobility LLC
• First Coast Pain and Spine Center LLC
• First Coast Pain Consultants PLLC
• First Coast Pain Management
• First Coast Physical Therapy Inc
• First Coast Pulmonary Associates

• Oral & Maxillofacial Surgery (D.M.D.) in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.