Jeffrey Taylor Jarrett, DDS
Individual provider Active NPI Dentist · Hideaway, TX
NPI 1245360668 · NPPES record last updated Sep 7, 2011
Key facts
- NPI
- 1245360668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 11937 (TX)
- Practice address
- 322 Highlander HTS
Hideaway, TX 75771-5232 - Phone
- (817) 716-1763
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11937 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11937 | TX | Yes |
Addresses
Primary practice location
322 Highlander HTS
Hideaway, TX 75771-5232
Mailing address
322 Highlander HTS
Hideaway, TX 75771-5232
Phone (817) 716-1763
Other providers in Hideaway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.