NPIMap

Organization Active NPI

Jaxoms, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Cooper City, FL
National Provider Identifier
1992634612
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
JAXOMS, P.A.
Practice address
9900 Stirling Rd Ste 300
Cooper City, FL 33024-8066
Phone
(402) 805-4516
NPI assigned
May 18, 2026
Organization subpart
Yes
Parent organization
JAXOMS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

9900 Stirling Rd Ste 300
Cooper City, FL 33024-8066

Mailing address

9900 Stirling Rd Ste 300
Cooper City, FL 33024-8066
Phone (402) 805-4516

Other names 1

  • Coastal Dental Implants & Oral Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jaxoms PA4 organizations share this tax ID, including this one
Part of
Jaxoms PA

Other organizations with this tax ID 3

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

Locations

9900 Stirling Rd
Ste 300
Hollywood, FL 33024
Phone (402) 805-4516

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1992634612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 STIRLING RD STE 300",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "330248066",
            "telephone_number": "402-805-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 STIRLING RD STE 300",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "330248066",
            "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": "2026-05-18",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "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": "Coastal Dental Implants & Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.