FIRST COAST ORAL & FACIAL SURGERY, PA (NPI# 1356601249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356601249 |
| Entity Type | Organization |
| Organization Name | FIRST COAST ORAL & FACIAL SURGERY, PA |
| Practice Address |
319 W Town Place Suite 2 St Augustine FL 32092 |
| Mailing Address |
319 West Town Place #2 St. Augustine FL 32092 |
| Practice Telephone | 9045298889 |
| Mailing Telephone | 9045298889 |
| Mailing Fax Number | 9045298893 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2012-05-24 |
| Authorized Official Name | DR. THOMAS E STAKEM (PRESIDENT) |
| Authorized Official Telephone | 9045298889 |
| Authorized Official Credential | D.D.S., M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
319 W TOWN PLACE SUITE 2 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670146 | Kaitlyn Thomas | Speech-Language Pathologist | 111 Nature Walk Pkwy # B101, Saint Augustine, FL 32092 | 2019-07-10 |
| 1386168359 | Westminster Pines, Inc. | Skilled Nursing Facility | 235 Towerview Drive, St. Augustine, FL 32092 | 2017-08-01 |
| 1255852471 | St Vincent's Urgent Care Inc | Clinic/Center | 2001 Country Road 210 West, St Augustine, FL 32092 | 2017-06-28 |
| 1649702291 | Leonard Volpe | Physician Assistant | 745 Porta Rosa Cir, St Augustine, FL 32092 | 2017-04-03 |
| 1740630425 | Sierra Danielle Shultz | Behavioral Analyst | 2590 C H Arnold Rd, Saint Augustine, FL 32092 | 2016-06-14 |
| 1023467347 | Marylin Palackel James | Family Medicine | 110 Hampton Point Dr, St Augustine, FL 32092 | 2016-06-07 |
| 1790146462 | Florida Autism Center | Community/Behavioral Health | 124 Capulet Drive, St Augustine, FL 32092 | 2016-03-09 |
| 1174901458 | Kaylan Brady | Pediatrics | 70 Turin Terrace, Suite 220, St Augustine, FL 32092 | 2015-05-07 |
| 1245620368 | Angela Sanchez | Physician Assistant | 229 Adelanto Ave, St Augustine, FL 32092 | 2015-01-27 |
| 1053723700 | David Hamilton | Dentist | 149 Tuscan Way, St. Augustine, FL 32092 | 2014-05-29 |
| Find all providers in zip 32092 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811107253 | Charles D Milton Jr. | Oral & Maxillofacial Surgery | 319 W Town Pl, Suite 2 and 3, St Augustine, FL 32092-3101 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730747395 | Michael A. Pikos, Dds Pa | Oral & Maxillofacial Surgery | 11940 Sheldon Road, Tampa, FL 33626 | 2019-05-30 |
| 1447625579 | Michael M Hashemian Dmd Md Pa | Oral & Maxillofacial Surgery | 32 Seven Hills Dr, Spring Hill, FL 34609-0212 | 2015-12-01 |
| 1629486097 | Oral Surgery Associates | Oral & Maxillofacial Surgery | 195 W Highland Street, Altamonte Springs, FL 32714 | 2014-07-29 |
| 1043582331 | Scott E. Farber, Dds.,p.a | Oral & Maxillofacial Surgery | 5150 Curry Ford Rd, Orlando, FL 32812-8744 | 2012-02-01 |
| 1760613426 | Jason E. Portnof | Oral & Maxillofacial Surgery | 9980 Central Park Blvd N Ste 113, Boca Raton, FL 33428-1703 | 2009-07-29 |
| 1497984785 | Ricardo M Ortiz | Oral & Maxillofacial Surgery | 2929 Capital Medical Blvd, Tallahassee, FL 32308-4407 | 2009-07-08 |
| 1992983654 | Patricia Hornback Dmd | Oral & Maxillofacial Surgery | 2426 Jenks Ave, Panama City, FL 32405-4908 | 2008-02-05 |
| 1821290305 | Marvin Craig Diamond | Oral & Maxillofacial Surgery | 5521 Bilbao Pl, Sarasota, FL 34238-4708 | 2007-06-05 |
| 1912048240 | Facial Surgery Center Pa | Oral & Maxillofacial Surgery | 1371 Bedford Drive, Melbourne, FL 32940 | 2007-02-09 |
| 1942352810 | Martin J Milne | Oral & Maxillofacial Surgery | 25400 Us Highway 19 N Ste 201, Clearwater, FL 33763-2144 | 2007-01-18 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32092 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.