Individual provider Active NPI

Brett J Jaffrey, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Ridge, TN
National Provider Identifier
1336124577
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS0000002895 Issued in TN
Practice address
420 Laboratory Rd
Oak Ridge, TN 37830-6802
Phone
(865) 482-1319
Fax
(865) 481-3067
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS0000002895 TN Primary

Addresses

Primary practice location

420 Laboratory Rd
Oak Ridge, TN 37830-6802

Mailing address

420 Laboratory Rd
Oak Ridge, TN 37830-6802
Phone (865) 482-1319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2895TNMDChiropractor
DS0000002895TNMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336124577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LABORATORY RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306802",
            "telephone_number": "865-482-1319",
            "fax_number": "865-481-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LABORATORY RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306802",
            "telephone_number": "865-482-1319",
            "fax_number": "865-481-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFREY",
        "first_name": "BRETT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS0000002895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.