St. Johns Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ST. JOHNS ORAL SURGERY

Practice address

2050 Saint Johns Pkwy Ste 101
St Johns, FL 32259-4593

Phone

(904) 267-1295

Fax

(904) 299-2942

NPI assigned

Oct 16, 2024

Last updated

Oct 16, 2024By 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

Dr. Roger Myers, DMDNPI 1962518829

Title

Owner

Phone

(904) 200-4375

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, and the practitioner matching its NPPES authorized official.

• Roger Lee Myers, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • St Augustine, FL
  • NPI 1962518829
  NPD Authorized official

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1710707328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SAINT JOHNS MEDICAL PARK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864342",
            "telephone_number": "904-267-1295",
            "fax_number": "904-299-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SAINT JOHNS PKWY STE 101",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322594593",
            "telephone_number": "904-267-1295",
            "fax_number": "904-299-2942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Saint Johns Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320864342",
            "country_code": "US",
            "telephone_number": "904-267-1295",
            "fax_number": "904-299-2942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. JOHNS ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-200-4375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Spera
• SRS Medical LLC
• St Johns Chiropractic, PLLC (St. Johns Sport and Spine Chiropractic)
• St Vincent's Full Service Urgent Care, LLC
• St Vincents Health System Inc (Ascension St Vincent's St. Johns County)
• Fernando Santos Sta-Maria, RPT
• Kayla Jeanne Stadius, PT, DPT, EP-C
• Susan Gail Stanton, OTR/L
• Taylor Choi Steed, PA-C
• In Sun Steele

• 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 Oct 16, 2024; 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.