Individual provider Active NPI

Jeffrey W Holdcraft, DDS

  • Dentist
  • Tucson, AZ
National Provider Identifier
1093876682
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2300 Issued in AZ
Practice address
1St & Wetmore Dental 698 E Wetmore
Suite 370
Tucson, AZ 85705
Phone
(520) 293-7433
Fax
(520) 292-2084
NPI assigned
Dec 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2300 AZ Primary

Addresses

Primary practice location

1St & Wetmore Dental 698 E Wetmore
Suite 370
Tucson, AZ 85705

Mailing address

698 E Wetmore
Suite 370
Tucson, AZ 85705
Phone (520) 293-7433

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
I20160223000216 AZ Order and Referring Only - DentistPractitioner - Dentist 1759686108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2300AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093876682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 E WETMORE",
            "address_2": "SUITE 370",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85705",
            "telephone_number": "520-293-7433",
            "fax_number": "520-292-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ST & WETMORE DENTAL 698 E WETMORE",
            "address_2": "SUITE 370",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85705",
            "telephone_number": "520-293-7433",
            "fax_number": "520-292-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDCRAFT",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "2300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.