Jarred Lloyd Price, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28413 Issued in TX

Practice address

2441 21St St
Fort Campbell, KY 42223-5582

Phone

(707) 988-7512

NPI assigned

Sep 27, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1083965297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "270-798-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "707-988-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JARRED",
        "middle_name": "LLOYD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28413",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vladmir Powell, RN
• Jonathan R Poyourow, R.D.
• Gordon Troy Prairie, MD
• Hilary Preston, LCSW
• Samuel L Preston III, DO
• Joel Price, LCSW
• Tammy Price
• Angela June Priko, RN NCM
• Kevin Jon Pufall, P.T.
• Richard James Pugh, DDS

• General Practice Dentistry in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.