Individual provider Active NPI

Jiaming Geng

  • Dentist
  • Camp Lejeune, NC
National Provider Identifier
1376954495
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62540 Issued in CA
Practice address
Commanding Officer
2D Denbn/NDC, PSC 20130, 315 McHugh Blvd
Camp Lejeune, NC 28540-0130
Phone
(910) 451-2208
Fax
(910) 451-8036
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62540 CA Primary
Dentist 122300000X 8716753-9921 UT

Addresses

Primary practice location

Commanding Officer
2D Denbn/NDC, PSC 20130, 315 McHugh Blvd
Camp Lejeune, NC 28540-0130

Mailing address

Commanding Officer
2D Denbn/NDC, PSC 20130, 315 McHugh Blvd
Camp Lejeune, NC 28540-0130
Phone (910) 451-2208

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
62540CAMDDentist
8716753-9921UTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1376954495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMMANDING OFFICER",
            "address_2": "2D DENBN/NDC, PSC 20130, 315 MCHUGH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285400130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMANDING OFFICER",
            "address_2": "2D DENBN/NDC, PSC 20130, 315 MCHUGH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285400130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENG",
        "first_name": "JIAMING",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62540",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "8716753-9921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.