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General NPI Number Information
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NPI Number | 1811840267
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Entity Type | Organization
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Legal Business Name | JAXOMS, P.A.
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 9868 S STATE ROAD 7 STE 245
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-4474
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Country | US
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Telephone | 561-778-2914
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Fax | 561-778-2922
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Provider Business Mailing Address
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Address Line | 9868 S STATE ROAD 7 STE 245
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-4474
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Country | US
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Telephone | 561-778-2914
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Fax | 561-778-2922
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Authorized Official
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Title or Position | CREDENTIALING MANAGAER
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Name | JENN HERITAGE
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Credential |
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Telephone | 402-805-4516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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