Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Professional Dental Alliance of Jacksonville San Jose, PLLC

Organization General Practice Dentistry · NPI 1578113254

Professional Dental Alliance of Jacksonville San Jose, PLLC provides General Practice Dentistry in Jacksonville, Florida. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9776 San Jose Blvd Ste 7
Jacksonville, FL 32257-5464
Phone: (904) 201-3565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1578113254
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lauren Howard — Credentialing Specialist · (757) 576-5479
NPI enumeratedSeptember 16, 2019
Last updated in NPPESSeptember 16, 2019
Mailing address11 S Mill St Ste 200, New Castle, PA 16101-3680

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