Ronald Dean Jessup, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

0401008645 Issued in VA

Practice address

14245 Lee Hwy
Bristol, VA 24202-4317

Phone

(276) 628-8164

Fax

(276) 644-3145

NPI assigned

Oct 16, 2007

Last updated

Oct 28, 2010By the provider in NPPES

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

Other identifiers 3

Other names 1

• Dr. Ronald Dean Jessup, D.M.D., PC Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ronald D Jessup DMD PC

  dba Gentle Family Dentistry

  • General Practice Dentistry
  • Bristol, VA
  • NPI 1396706669
  NPD (past) Authorized official

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1184813164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14245 LEE HWY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024317",
            "telephone_number": "276-628-8164",
            "fax_number": "276-644-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245 LEE HWY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024317",
            "telephone_number": "276-628-8164",
            "fax_number": "276-644-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "RONALD",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401008645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "00701762",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007800568",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "041008645A",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "JESSUP, D.M.D., PC",
            "middle_name": "DEAN",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Brittany Leigh Jessee, DPT
• Alice Jessen, RPRS
• Daylin Johnson
• Susan K Johnson, FNP
• Johnston Memorial Hospital, Inc (Johnston Memorial Sleep Lab)
• Journeys Therapy Center, PLLC
• Just for Grins, PC

• Dentist in Bristol, VA
• Providers in Bristol, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.