Individual provider Active NPI

Jeffrey Craig Hambleton, D.D.S.

  • Periodontics
  • Lawrence, KS
National Provider Identifier
1114135381
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
5440 Issued in KS
Practice address
1440 Wakarusa Dr
Ste 300
Lawrence, KS 66049-4090
Phone
(785) 841-1188
Fax
(785) 841-1469
NPI assigned
May 19, 2007
Sex
Male
Sole proprietor
Yes

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
Periodontics 1223P0300X 5440 KS Primary

Addresses

Primary practice location

1440 Wakarusa Dr
Ste 300
Lawrence, KS 66049-4090

Mailing address

1440 Wakarusa Dr
Ste 300
Lawrence, KS 66049-4090
Phone (785) 841-1188

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5440KSMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114135381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 WAKARUSA DR",
            "address_2": "STE 300",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494090",
            "telephone_number": "785-841-1188",
            "fax_number": "785-841-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 WAKARUSA DR",
            "address_2": "STE 300",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494090",
            "telephone_number": "785-841-1188",
            "fax_number": "785-841-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLETON",
        "first_name": "JEFFREY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "5440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

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.