NPIMap

Organization Active NPI

Jebediah S Christy DDS - Pooler PLLC

  • Dental Clinic/Center
  • Pooler, GA
National Provider Identifier
1043617293
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
JEBEDIAH S CHRISTY DDS - POOLER PLLC
Practice address
276 Pooler Pkwy Ste a
Pooler, GA 31322-5163
Phone
(912) 330-9070
NPI assigned
Dec 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
Dr. Jebediah S Christy, DDS
Title
DDS/Owner
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

276 Pooler Pkwy Ste a
Pooler, GA 31322-5163

Mailing address

PO Box 3189
Syracuse, NY 13220-3189

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Locations

276 Pooler Pkwy
Ste A
Pooler, GA 31322
Phone (207) 737-9660

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1043617293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 POOLER PKWY STE A",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313225163",
            "telephone_number": "912-330-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEBEDIAH S CHRISTY DDS - POOLER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "CHRISTY",
        "authorized_official_first_name": "JEBEDIAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.