Individual provider Active NPI

John Rene Jayman, DDS

  • Dentist
  • Tucson, AZ
National Provider Identifier
1073724175
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8716 Issued in AZ
Practice address
6126 E Speedway Blvd
Tucson, AZ 85712-5127
Phone
(520) 298-2379
NPI assigned
May 24, 2007
Last updated
May 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8716 AZ Primary

Addresses

Primary practice location

6126 E Speedway Blvd
Tucson, AZ 85712-5127

Mailing address

1768 S Sunlit Sand PL
Tucson, AZ 85748-7753
Phone (410) 259-4867

Other identifiers 1

IdentifierTypeStateIssuer
D08574776OtherAZDRIVERS LICENSE

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
I20160929001859 AZ Order and Referring Only - DentistPractitioner - Dentist 9335436674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8716AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Teeth - Olive P.C. General Practice Past Accepting new patients
Perfect Teeth - North Wilmot PC General Practice PastSince May 7, 2023 Accepting new patients
Wayne S Silverman, D.D.S. Dentist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1073724175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 S SUNLIT SAND PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857487753",
            "telephone_number": "410-259-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 E SPEEDWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857125127",
            "telephone_number": "520-298-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYMAN",
        "first_name": "JOHN",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "D08574776",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.