Robert Elton Jarvis II, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DF029956 Issued in CA

Practice address

2211 4TH St
Santa Rosa, CA 95404-3210

Phone

(707) 575-1198

Fax

(707) 575-0818

NPI assigned

Mar 21, 2007

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 CA

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

Practice roles

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.

• Dr.Robert E. Jarvis II, a California Professional Dental Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Rosa, CA
  • NPI 1922380781
  NPD (past) Authorized official

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275659336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043210",
            "telephone_number": "707-575-1198",
            "fax_number": "707-575-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043210",
            "telephone_number": "707-575-1198",
            "fax_number": "707-575-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "ROBERT",
        "middle_name": "ELTON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DF029956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zeena Janowsky, MFT
• Nicole Erika Janson, MFT INTERN
• Brian Keith Jaramillo, CMT
• Kasandra Jaramillo
• John B Jarvis, PH.D.
• Adam Douglas Jasa
• Danielle Shereen Javadi
• Wendy Javier Chan
• Aruna Krishnan Jayaraman, M.D., M.H.S.
• Jajuan Jaymes

• Oral and Maxillofacial Surgery (Dentist) in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.