Everett Jewett

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12028 Issued in GA

Practice address

1390 Montreal Rd
Tucker, GA 30084-8143

Phone

(770) 934-9700

NPI assigned

Jan 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 GA

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

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205989787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300848143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300848143",
            "telephone_number": "770-934-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWETT",
        "first_name": "EVERETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "12028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Marchele Jean-Baptiste, FNP-C
• Jenelle Martin, M.D., P.C.
• Jill C Jenkins, LCSW
• Danny Jeon, DMD
• Jessica M Ringsmuth LLC
• Paul Joe, D.O.
• Myasia John
• Tracy M John, PT, DPT
• Cheryl Amyle Johnson Ransaw, L.C.S.W., C.E.A.P.
• Calvin A Johnson Jr., HHP, LMMT

• General Practice Dentistry in Tucker, GA
• Providers in Tucker, GA by specialty
• General Practice Dentistry in Georgia

• 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.
• 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.