Jeffrey J. Caldwell, Sr., D.D.S., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5898 Issued in NC

Legal business name

JEFFREY J. CALDWELL, SR., D.D.S., P.A.

Practice address

405 S McCaskey Rd Ste C
Williamston, NC 27892-2160

Phone

(252) 792-1101

Fax

(252) 792-1102

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey J. Caldwell Sr., D.D.S.NPI 1740388958

Title

President

Phone

(252) 792-1101

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Jerome Caldwell Sr., D.D.S.

  • General Practice Dentistry
  • Williamston, NC
  • NPI 1740388958
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013014380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S MCCASKEY RD STE C",
            "address_2": "P. O. BOX 621",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922160",
            "telephone_number": "252-792-1101",
            "fax_number": "252-792-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S MCCASKEY RD STE C",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922160",
            "telephone_number": "252-792-1101",
            "fax_number": "252-792-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY J. CALDWELL, SR., D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-792-1101",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8991301",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Williamston, NC
• Providers in Williamston, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.