First Coast Dental Center, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FIRST COAST DENTAL CENTER, PLLC

Practice address

10991 San Jose Blvd Ste 54
Jacksonville, FL 32223-6655

Phone

(904) 268-0606

Fax

(904) 260-7601

NPI assigned

Apr 2, 2025

Organization subpart

No

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

Authorized official

Name

Samantha Plummer

Title

Practice Manager

Phone

(904) 671-4715

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1437953122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10991 SAN JOSE BLVD STE 54",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236655",
            "telephone_number": "904-268-0606",
            "fax_number": "904-260-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10991 SAN JOSE BLVD STE 54",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236655",
            "telephone_number": "904-268-0606",
            "fax_number": "904-260-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST DENTAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "PLUMMER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "904-671-4715"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Community Support Services
• First Coast Community Support Services
• First Coast Community Wellness Services LLC
• First Coast Counseling and Life Coaching, Inc.
• First Coast Counseling and Recovery
• First Coast Dermatology P a
• First Coast Diabetes Institute, LLC
• First Coast Eye Associates, PA
• First Coast Eyewear Inc
• First Coast Family Medicine PA

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, 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 Apr 2, 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.