Jaxoms, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

JAXOMS, P.A.

Doing business as

Gulf Coast Dental Implants & Oral Surgery

Practice address

17425 Bridge Hill CT Ste 103
Tampa, FL 33647-3657

Phone

(402) 805-4516

NPI assigned

Jun 26, 2026

Organization subpart

Yes

Parent organization

JAXOMS, P.A.As reported in NPPES

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

Authorized official

Name

Jenn Heritage

Title

Credentialing Manager

Phone

(402) 805-4516

Specialties & licenses 1

Addresses

Other names 1

• Gulf Coast Dental Implants & Oral Surgery Doing business as

Tax ID family

Jaxoms PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Jaxoms, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Jacksonville, FL
  • NPI 1316821044
  NPD tax ID
• Jaxoms, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Boynton Beach, FL
  • NPI 1811840267
  NPD tax ID
• Jaxoms, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Cooper City, FL
  • NPI 1992634612
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Jaxoms, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Jacksonville, FL
  • NPI 1316821044
  NPPES parent name

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1619893336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17425 BRIDGE HILL CT STE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17425 BRIDGE HILL CT STE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473657",
            "telephone_number": "402-805-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAXOMS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAXOMS, P.A.",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "HERITAGE",
        "authorized_official_first_name": "JENN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "402-805-4516"
    },
    "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": "Gulf Coast Dental Implants & Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neeraja Jasthi, DMD
• Cresha Rene Jaurequi, APRN
• Maral Javadifar, DPT
• Christina Tan Javete, MS
• Jawan Ayer MD, LLC
• Patricia Ann Jay, ARNP
• Jayant C Gajera, M.D., P.a.
• Lalitha Jayanth
• Nushani Lanka Jayaratne, MD MPH
• Jaydeep Patel MD PA

• Oral and Maxillofacial Surgery (Dentist) in Tampa, FL
• Providers in Tampa, 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 Jun 26, 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.