Individual provider Active NPI

Jay Alan Pfister, DDS PA

  • Dentist
  • Beaumont, TX
National Provider Identifier
1174622872
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14350 Issued in TX
Practice address
8105 Gladys Ave
Beaumont, TX 77706
Phone
(409) 866-2843
Fax
(409) 866-4500
NPI assigned
Sep 21, 2006
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 14350 TX Primary

Addresses

Primary practice location

8105 Gladys Ave
Beaumont, TX 77706

Mailing address

8105 Gladys Ave
Beaumont, TX 77706
Phone (409) 866-2843

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14350TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison Luke, PLLC PastSince Sep 20, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174622872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 GLADYS AVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-866-2843",
            "fax_number": "409-866-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8105 GLADYS AVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-866-2843",
            "fax_number": "409-866-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFISTER",
        "first_name": "JAY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

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.