Individual provider Active NPI

Jeffrey Steven Wert, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
National Provider Identifier
1376660035
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D13704 Issued in TX
Practice address
3338 Oakwell Court
#204
San Antonio, TX 78218
Phone
(210) 656-3301
Fax
(210) 656-3304
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 D13704 TX Primary

Addresses

Primary practice location

3338 Oakwell Court
#204
San Antonio, TX 78218

Mailing address

3338 Oakwell Court
#204
San Antonio, TX 78218
Phone (210) 656-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070830000818 TX Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 3971696329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13704TXMDAddiction (Substance Use Disorder) Counselor
D13704TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376660035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 OAKWELL COURT",
            "address_2": "#204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78218",
            "telephone_number": "210-656-3301",
            "fax_number": "210-656-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 OAKWELL COURT",
            "address_2": "#204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78218",
            "telephone_number": "210-656-3301",
            "fax_number": "210-656-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERT",
        "first_name": "JEFFREY",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "D13704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.