Jeffry Dean Fletcher, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60316917 Issued in WA

Practice address

2902 164TH St SW
Suite C-1
Lynnwood, WA 98087-3201

Phone

(425) 329-7756

Fax

(425) 741-9711

NPI assigned

Aug 12, 2008

Last updated

Dec 8, 2016By 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

Medicare fee-for-service enrollment

Enrolled in WA

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

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1184870024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 BROADWAY E",
            "address_2": "SUITE C-1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025023",
            "telephone_number": "206-757-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 164TH ST SW",
            "address_2": "SUITE C-1",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980873201",
            "telephone_number": "425-329-7756",
            "fax_number": "425-741-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JEFFRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60316917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Michelle Fitzgerald
• Patrick Thomas Flanagan, M.D.
• Leslie C Fleming, MA, LMHC
• Elizabeth Fleshman
• Adrien Fletcher, LMP
• Alexandru Viorel Florea
• Erick Flores-Gomez
• Emily Flores
• Adrian Florian
• Don Benjamin Floyd, D.P.M.

• General Practice Dentistry in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.