Active NPI
Jason Carl Edwards, D.D.S.
- Dentist
- Wichita, KS
National Provider Identifier
1043635337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60939
- Practice address
- 9339 E 21St St N
Wichita, KS 67206-2971 - Phone
- (316) 630-9339
- NPI assigned
- Feb 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60939 | KS | Primary |
Addresses
Primary practice location
9339 E 21St St N
Wichita, KS 67206-2971
Mailing address
9339 E 21St St N
Wichita, KS 67206-2971
Phone (316) 630-9339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60939 | KS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393200000000",
"number": "1043635337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9339 E 21ST ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672062971",
"telephone_number": "316-630-9339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9339 E 21ST ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672062971",
"telephone_number": "316-630-9339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JASON",
"middle_name": "CARL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-24",
"last_updated": "2014-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "60939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.