James Kevin Jetton, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

33939 Issued in CA

Practice address

Yucaipa Valley Spanish Sda Church
12504 4TH St
Yucaipa, CA 92399

Phone

(909) 518-4133

Fax

(909) 790-7206

NPI assigned

Jun 7, 2006

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

Practice roles

Locations

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.

• Department of State Hospitals

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1295775252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37441 IRONWOOD DR",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923997024",
            "telephone_number": "909-518-4133",
            "fax_number": "909-790-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "YUCAIPA VALLEY SPANISH SDA CHURCH",
            "address_2": "12504 4TH ST",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-518-4133",
            "fax_number": "909-790-7206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3102 East Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Patton",
            "state": "CA",
            "postal_code": "92369",
            "country_code": "US",
            "telephone_number": "909-425-7000",
            "fax_number": "909-425-7520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JETTON",
        "first_name": "JAMES",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "33939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Anthony Jara, RPH
• Robert E. Jarrett, D.C.
• Jasleen Singh MD Professional
• Jeff T. Grange, MD
• Brett David Jeffries, PHARMD
• Kristina Jimenez, LVN
• Peter Nicholas Jimenez, D.D.S
• Mustapha John
• Dana Leah Johnson
• Mariah Johnson

• Dentist in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.