MEDICARE: JON WINDOM DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN14686	FL

General Provider Information

NPI Number	:	1205043809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON WINDOM DDS

Provider Business Mailing Address
First Line	:	105 HERITAGE CIR
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-4208
Country	:	US
Telephone Number	:	386-673-1257
Fax Number	:

Provider Business Practice Location Address
First Line	:	1081 A1A BEACH BLVD
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32080-6733
Country	:	US
Telephone Number	:	904-471-3291
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/02/2015

Similar Medicare Providers

1184659484 — VICTORIA JEAN CAMP DPM, PA
Practice Location Address:

1093 A1A BEACH BLVD , PMB 235
ST AUGUSTINE, FL
32080-6733

Practice Phone: 904-814-4904
Practice Fax:

1760698104 — MS. BARBARA JANE PATTERSON ARNP
Practice Location Address:

1093 A1A BEACH BLVD , #109 ANASTASIA PLAZA
ST AUGUSTINE BEACH, FL
32080-6733

Practice Phone: 904-234-5322
Practice Fax: 904-234-5322

1790929438 — MRS. TARA LOVETT DETTRA L.M., C.P.M.
Practice Location Address:

1093 A1A BEACH BLVD , PMB 285
SAINT AUGUSTINE, FL
32080-6733

Practice Phone: 904-540-7994
Practice Fax: 904-471-4980

1235452541 — DR. SHANTA WARRIS SINGH D.D.S.
Practice Location Address:

1081 A1A BEACH BLVD
ST AUGUSTINE, FL
32080-6733

Practice Phone: 904-417-3291
Practice Fax:

1104418102 — MISS MORGAN R FARRELL RDH
Practice Location Address:

1081 A1A BEACH BLVD
ST AUGUSTINE, FL
32080-6733

Practice Phone: 904-471-3291
Practice Fax:

1821664178 — COAST DENTAL P.A.
Practice Location Address:

1081 A1A BEACH BLVD
ST AUGUSTINE, FL
32080-6733

Practice Phone: 904-471-3291
Practice Fax: 904-471-3783

Directions to “ JON WINDOM DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.