Individual provider Active NPI

Jeffery Allen Borst, DDS

  • General Practice Dentistry
  • Erie, PA
National Provider Identifier
1306078654
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS026944L Issued in PA
Practice address
1611 Peach St Ste 465
Erie, PA 16501-2129
Phone
(814) 456-8548
Fax
(814) 453-4857
NPI assigned
Aug 20, 2009
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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 DS026944L PA Primary

Addresses

Primary practice location

1611 Peach St Ste 465
Erie, PA 16501-2129

Mailing address

1202 State St
Erie, PA 16501-1914
Phone (814) 455-7222

Other practice location 1

1202 State St
Erie, PA 16501-1914
Phone (814) 452-4262

Other practice location 2

2120 E 10th St
Erie, PA 16511-3111
Phone (814) 464-0307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251027002272 PA Practitioner - Dentist 3678957644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1202 State St
Erie, PA 16501-1914

PO Box
Suite 369
Erie, PA 16512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS026944LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Net Current Accepting new patients
Community Health Net CurrentSince Oct 2, 2025 Accepting new patients
Community Health Net CurrentSince Oct 2, 2025 Accepting new patients
Community Health Net Past Accepting new patients
Community Health Net Past Accepting new patients

Locations

1202 State St
Erie, PA 16501
Phone (814) 454-4530

1611 Peach St
Ste 465
Erie, PA 16501
Phone (814) 453-4718

Interoperability endpoints

  • Direct secure messaging: jeffery.borst.p1@direct.communityhealthnet.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1306078654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011914",
            "telephone_number": "814-455-7222",
            "fax_number": "814-453-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 PEACH ST STE 465",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012129",
            "telephone_number": "814-456-8548",
            "fax_number": "814-453-4857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165011914",
            "country_code": "US",
            "telephone_number": "814-452-4262",
            "fax_number": "814-453-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2120 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165113111",
            "country_code": "US",
            "telephone_number": "814-464-0307",
            "fax_number": "814-453-4857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORST",
        "first_name": "JEFFERY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026944L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.