Healthcare Provider Details

I. General information

NPI: 1447166764
Provider Name (Legal Business Name): JEFFREY ALLEN DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 US HIGHWAY 1
ROCKLEDGE FL
32955-2128
US

IV. Provider business mailing address

980 US HIGHWAY 1
ROCKLEDGE FL
32955-2128
US

V. Phone/Fax

Practice location:
  • Phone: 321-632-5323
  • Fax: 321-632-6834
Mailing address:
  • Phone: 321-632-5323
  • Fax: 321-632-6834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY ALLEN
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 321-632-5323