# ORAL AND MAXILLOFACIAL SURGERY OF JACKSONVILLE, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Jacksonville Surgical Arts Oral and Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356253199
- **Authorized official:** VINCENT PERCIACCANTE (OWNER)
- **Authorized official phone:** (904) 820-8956

## Contact information

- **Practice address:** 95 JAIDEV ROAD, BLDG 10, SUITE101, ST. JOHNS, FL 32259-1140
- **Practice address phone:** (904) 820-8956
- **Practice address fax:** (904) 820-8957
- **Mailing address:** 95 JAIDEV ROAD, BLDG 10, SUITE101, ST. JOHNS, FL 32259-1140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2026
- **Last updated:** 09/17/2026