Victa Jeron Edwards, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18764 Issued in TX

Practice address

1801 Merlin St
Bay City, TX 77414-3131

Phone

(979) 323-8400

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lawndale Dental, PA

  • General Practice Dentistry
  • Bay City, TX
  • NPI 1760543698
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1003976747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 MERLIN ST",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143131",
            "telephone_number": "979-323-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 MERLIN ST",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143131",
            "telephone_number": "979-323-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "VICTA",
        "middle_name": "JERON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "B18764-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1333247-12",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dohaeris LLC
• Dr. Earl S. Brown Professional Corp
• Valeria Dubourdieu
• E Medical Group, Inc
• Economic Action Committee of the Gulf Coast
• Antoine Egbe Bessong Tabot, MD
• El Campo Memorial Hospital
• El Campo Memorial Hospital
• Edsel Estabillo, MSN,APRN,FNP-C,CEN
• Stephanie Evans, FNP-C

• General Practice Dentistry in Bay City, TX
• Providers in Bay City, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.