Active NPI
Jeffrey Halvor Lind, DMD
- General Practice Dentistry
- La Jolla, CA
National Provider Identifier
1083783138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 31946
- Practice address
- 4130 La Jolla Village Dr
Suite 202
La Jolla, CA 92037 - Phone
- (858) 535-1478
- Fax
- (858) 535-1463
- NPI assigned
- Nov 6, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31946 | CA | Primary |
| General Practice Dentistry | 1223G0001X | D5968 | OR |
Addresses
Primary practice location
4130 La Jolla Village Dr
Suite 202
La Jolla, CA 92037
Mailing address
4130 La Jolla Village Dr
Suite 202
La Jolla, CA 92037
Phone (858) 535-1478
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 |
|---|---|---|---|
| D5968 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083783138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4130 LA JOLLA VILLAGE DR",
"address_2": "SUITE 202",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-535-1478",
"fax_number": "858-535-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4130 LA JOLLA VILLAGE DR",
"address_2": "SUITE 202",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-535-1478",
"fax_number": "858-535-1463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIND",
"first_name": "JEFFREY",
"middle_name": "HALVOR",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "31946",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D5968",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.