Individual provider Active NPI

Rashad M Jefferson, D.D.S.

  • General Practice Dentistry
  • Clearwater, FL
National Provider Identifier
1275678609
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN31635 Issued in FL
Practice address
14100 58TH St N
Clearwater, FL 33760-3758
Phone
(727) 824-8181
Fax
(727) 824-8165
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN31635 FL Primary

Addresses

Primary practice location

14100 58TH St N
Clearwater, FL 33760-3758

Mailing address

14100 58TH St N
Clearwater, FL 33760-3758
Phone (727) 824-8181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20260620000433 FL Practitioner - Dentist 7810274610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Maryland at Baltimore School of Dentistry, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14100 58TH St N
Clearwater, FL 33760-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN31635FLMDGeneral Practice Dentistry

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1275678609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603758",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603758",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "RASHAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN31635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.