Organization
JAXOMS, P.A.
Active
Organization
JAXOMS, P.A.
Active
Parent organization
JAXOMS, P.A.
Other names
Coastal Dental Implants & Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
JAXOMS, P.A.
Authorized official
JENN HERITAGE (CREDENTIALING MANAGER)
(402) 805-4516
Entity
Organization
Contact information
Practice address
9900 STIRLING RD STE 300, COOPER CITY, FL 33024-8066
(402) 805-4516
Mailing address
9900 STIRLING RD STE 300, COOPER CITY, FL 33024-8066
(402) 805-4516
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/18/2026
Last updated
05/19/2026
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