Florida Periodontal Specialists PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

FLORIDA PERIODONTAL SPECIALISTS PLLC

Practice address

12161 County Road 103 Ste 101
Oxford, FL 34484-2986

Phone

(352) 259-6799

NPI assigned

Feb 25, 2026

Last updated

Feb 25, 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

Jennifer Heritage

Title

Credentialing Manager

Phone

(402) 805-4516

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1771977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1831043868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12161 COUNTY ROAD 103 STE 101",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842986",
            "telephone_number": "352-259-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12161 COUNTY ROAD 103 STE 101",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842986",
            "telephone_number": "352-259-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PERIODONTAL SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "HERITAGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "402-805-4516"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Oxford, FL
• Providers in Oxford, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.