Active NPI
Jay Heeren, DDS
- Dentist
- Sturgis, SD
National Provider Identifier
1194087007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D0997
- Practice address
- 866 Lazelle St
Sturgis, SD 57785-1611 - Phone
- (605) 347-8880
- Fax
- (605) 347-2011
- NPI assigned
- Jun 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D0997 | SD | Primary |
Addresses
Primary practice location
866 Lazelle St
Sturgis, SD 57785-1611
Mailing address
866 Lazelle St
Sturgis, SD 57785-1611
Phone (605) 347-8880
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0997 | SD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TJ Loftus Dental P.C. | Past | Accepting new patients | |
| Summerset Dental LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Summerset, SD
- NPI 1518807528
-
- General Practice Dentistry
- Sturgis, SD
- NPI 1578624409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1194087007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 LAZELLE ST",
"city": "STURGIS",
"state": "SD",
"postal_code": "577851611",
"telephone_number": "605-347-8880",
"fax_number": "605-347-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "866 LAZELLE ST",
"city": "STURGIS",
"state": "SD",
"postal_code": "577851611",
"telephone_number": "605-347-8880",
"fax_number": "605-347-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEEREN",
"first_name": "JAY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-15",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SD",
"license": "D0997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sturgis, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.