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904 Implants and Dentures Pllc

Dental Clinic/Center in Jacksonville, FL · enumerated 2021 · authorized official William Russell, Co-Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1700549136

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Registry record

Entity type Organization (Type 2)
Legal business name 904 Implants and Dentures Pllc
Practice address 11645 Beach Blvd Ste 101, Jacksonville, FL, 32246
Phone (904) 999-9000
Enumeration date Oct 21, 2021
Last updated in NPPES Oct 21, 2021

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name William Russell
Title Co-Owner
Phone (803) 665-6998

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is 904 Implants and Dentures Pllc?
904 Implants and Dentures Pllc is registered in NPPES as a Dental Clinic/Center (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-10-21.