Jeffrey V Sue, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

47805 Issued in CA

Practice address

7916 Pebble Beach Dr Ste 101
Citrus Heights, CA 95610-7790

Phone

(916) 962-0577

Fax

(916) 962-0584

NPI assigned

Jan 29, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Weideman Professional Dental Corporation

  • Pediatric Dentistry
  • Citrus Heights, CA
  • NPI 1578575023
  NPD (past)

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1386982114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7916 PEBBLE BEACH DR STE 101",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107790",
            "telephone_number": "916-962-0577",
            "fax_number": "916-962-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 PEBBLE BEACH DR STE 101",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107790",
            "telephone_number": "916-962-0577",
            "fax_number": "916-962-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUE",
        "first_name": "JEFFREY",
        "middle_name": "V",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "47805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah-Brooke Jessica Stiles, LCSW # 95317
• Stoneridge Care Home
• Chelsie Blue Strauss
• Kathryn Dawnine Strong
• Zachary Colton Sturgill
• Helene Sullivan
• Jennifer Michelle Sullivan
• Paula Sullivan
• Xiuyan Sun
• Sungarden Villa Inc.

• Pediatric Dentistry in Citrus Heights, CA
• Providers in Citrus Heights, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.