Jeffrey Minor, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1002990 Issued in IL

Practice address

6294 State Highway 154
Sesser, IL 62884-2163

Phone

(618) 625-6979

Fax

(618) 625-5362

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2011.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1013074947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "address_2": "REA CLINIC",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62822",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6294 STATE HIGHWAY 154",
            "city": "SESSER",
            "state": "IL",
            "postal_code": "628842163",
            "telephone_number": "618-625-6979",
            "fax_number": "618-625-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "JEFFREY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "1002990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Lynn Hawkins, RDH
• Erin Klamm
• Peter Wallace Lewis, PA-C
• Linda K Miller, RN
• Pamela Miller
• Malori Newbury, FNP-C
• Melissa K Odle, FNP
• Toni K Owens, RN
• James J Pavlovich, M.D.
• Jilissa M Payne, RDH

• All providers in Sesser, IL
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.