Jeffrey M Van Ness, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10851471-8903 Issued in UT

Practice address

15301 Warren Shingle Rd
Beale AFB, CA 95903-1905

Phone

(925) 917-9720

NPI assigned

Apr 16, 2018

Last updated

Dec 1, 2023By the provider in NPPES

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

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": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1174010268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AIR FORCE BASE DENTIST CLINIC",
            "address_2": "15301 WARREN SHINGLE ROAD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "95903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031905",
            "telephone_number": "925-917-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NESS",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-16",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "10851471-8903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Sturman
• Rebecca Lynne Thompson, LCSW
• Grant Tong, PT
• Tora Jean Tornbom, MD
• Vladimir Vader, DMD
• Richelle L Vanburen-Walls, LSW
• Lijah Vann Gardner, DO
• Paul D Vu, M.D.
• Zachary Wajvoda, PA-C
• Wesley Wander, D.O.

• Dentist in Beale AFB, CA
• Providers in Beale AFB, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.