Individual provider Active NPI

Jeffrey Halvor Lind, DMD

  • General Practice Dentistry
  • La Jolla, CA
National Provider Identifier
1083783138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31946 Issued in CA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
D5968ORMDGeneral 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.

Verify at the official NPI Registry.