Jeffrey Ray Nelson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5238 Issued in OK

Practice address

1109 Highway 70 N
Kingston, OK 73439-8232

Phone

(580) 564-9994

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nelson Family Dentistry

  • General Practice Dentistry
  • Kingston, OK
  • NPI 1649445453
  NPD (past) Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124149455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1360",
            "address_2": "1109 N HWY 70",
            "city": "KINGSTON",
            "state": "OK",
            "postal_code": "734391360",
            "telephone_number": "580-564-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 HIGHWAY 70 N",
            "city": "KINGSTON",
            "state": "OK",
            "postal_code": "734398232",
            "telephone_number": "580-564-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JEFFREY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni McLemore, APRN-CNP
• Carrie Moore, MS
• Samantha Darlene Moore
• Shannan Myers
• Nelson Family Dentistry
• Abby Lee Olmstead, M.S.
• Nikki Danielle Patterson, M.S. CCC-SLP
• Kirstyn Plymale, LPC
• Rehab Medical LLC
• Patricia Reid

• General Practice Dentistry in Kingston, OK
• Providers in Kingston, OK by specialty
• General Practice Dentistry in Oklahoma

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.