NPIMap

Organization Active NPI

Jeffries Dental, P.C.

  • General Practice Dentistry
  • Worland, WY
National Provider Identifier
1316147952
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1005 Issued in WY
Legal business name
JEFFRIES DENTAL, P.C.
Practice address
3313 Paintbrush Lane
Worland, WY 82401
Phone
(307) 347-3994
Fax
(307) 347-3697
NPI assigned
Jul 23, 2007
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Dr. L. Carl Jeffries, D.D.S.NPI 1174723357
Title
Dentist-Co-Owner
Phone
(307) 388-0137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1041 WY
General Practice Dentistry 1223G0001X 1005 WY Primary

Addresses

Primary practice location

3313 Paintbrush Lane
Worland, WY 82401

Mailing address

3313 Paintbrush Lane
Worland, WY 82401
Phone (307) 347-3994

Other identifiers 4

IdentifierTypeStateIssuer
113827800MedicaidWY
113370500MedicaidWY
113829400MedicaidWY
113828600MedicaidWY

National Provider Directory

National Provider Directory

Locations

1409 Howell Ave
Worland, WY 82401
Phone (307) 349-6163

3313 Paintbrush Ln
Worland, WY 82401
Phone (307) 347-3994

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1316147952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 PAINTBRUSH LANE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "82401",
            "telephone_number": "307-347-3994",
            "fax_number": "307-347-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 PAINTBRUSH LANE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "82401",
            "telephone_number": "307-347-3994",
            "fax_number": "307-347-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFRIES DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "JEFFRIES",
        "authorized_official_first_name": "L. CARL",
        "authorized_official_title_or_position": "DENTIST-CO-OWNER",
        "authorized_official_telephone_number": "307-388-0137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1041",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113827800",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113370500",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113829400",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113828600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worland, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.