Jeromy R. Dixson, D.M.D., P.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

729364 Issued in WA

Legal business name

JEROMY R. DIXSON, D.M.D., P.S.

Doing business as

Smiles Dental

Practice address

820 Ocean Beach Hwy
Suite 110
Longview, WA 98632-4080

Phone

(360) 577-0566

Fax

(360) 423-3343

NPI assigned

Aug 18, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Dana Franchesca Hultgren

Title

Insurance Manager

Phone

(360) 577-1440

Specialties & licenses 1

Addresses

Other names 1

• SMILES DENTAL Doing business as

Locations

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1093020778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 OCEAN BEACH HWY",
            "address_2": "SUITE 110",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324080",
            "telephone_number": "360-577-0566",
            "fax_number": "360-423-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 OCEAN BEACH HWY",
            "address_2": "SUITE 110",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324080",
            "telephone_number": "360-577-0566",
            "fax_number": "360-423-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROMY R. DIXSON, D.M.D., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "HULTGREN",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "FRANCHESCA",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "360-577-1440",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "729364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILES DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Makayla Jenkins
• Jonathan Christian Jennings
• Andrew Jensen, CRNA
• Joanna Jensen
• Tammy L Jensen, LMP
• Donna Marie Jessen, RDH
• Cynthia Jewett, BACHELORS
• June Li Jia, M.D. PH.D.
• John Berwind DDS PS
• Corey S Johnson, M.D.

• General Practice Dentistry in Longview, WA
• Providers in Longview, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.