Individual provider Active NPI

Daniel D Jameson, DMD

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1053052902
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1441 N 12TH St FL 3
Phoenix, AZ 85006-2837
Phone
(602) 521-5150
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1441 N 12TH St FL 3
Phoenix, AZ 85006-2837

Mailing address

5223 N Boxman Dr
Monticello, IN 47960-7503
Phone (219) 629-1431

Other practice location 1

5223 N Boxman Dr
Monticello, IN 47960-7503
Phone (219) 629-1431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220725002791 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335520162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1053052902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5223 N BOXMAN DR",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479607503",
            "telephone_number": "219-629-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5223 N Boxman Dr",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "IN",
            "postal_code": "479607503",
            "country_code": "US",
            "telephone_number": "219-629-1431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMESON",
        "first_name": "DANIEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.