Kevin Todd Jeffers, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51942 Issued in CA

Practice address

3912 Princeton Dr
Santa Rosa, CA 95405-7014

Phone

(707) 528-6343

Fax

(707) 528-0316

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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 CA

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

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.

• Jeffers Dentistry Partnership

  • General Practice Dentistry
  • Santa Rosa, CA
  • NPI 1285035527
  NPD (past) Authorized official
• KM Jeffers Dental Corp

  • General Practice Dentistry
  • Ukiah, CA
  • NPI 1669875381
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1184725830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 MOSS HOLLOW CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041567",
            "telephone_number": "707-542-1942",
            "fax_number": "707-528-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 PRINCETON DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057014",
            "telephone_number": "707-528-6343",
            "fax_number": "707-528-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "KEVIN",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Deana L Jeane, ND
• Jeannette B. Currie, M.D. , Inc.
• Jeannie L Pflum DO Inc
• Jeffers Dentistry Partnership
• Dwight Jeffers
• Robert P Jeffers, D.D.S.
• Marie Antionette Jefferson
• David John Jeffries, C.O.
• Jada Jeffries, ASW
• Vanessa Renee Jellison

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.