Ronald D Jessup DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1223G0001X Issued in VA

Legal business name

RONALD D JESSUP DMD PC

Doing business as

Gentle Family Dentistry

Practice address

14245 Lee Hwy
Bristol, VA 24202-4317

Phone

(276) 628-8164

Fax

(276) 644-3145

NPI assigned

Mar 28, 2006

Last updated

Jul 10, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ronald D Jessup, DMDNPI 1184813164

Title

Owner

Phone

(276) 628-8164

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gentle Family Dentistry Doing business as

Locations

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.

• Ronald Dean Jessup, D.M.D.

  • Dentist
  • Bristol, VA
  • NPI 1184813164
  NPD (past) Authorized official
• Roy S Shelburne, DDS

  • General Practice Dentistry
  • Bristol, VA
  • NPI 1003926940
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1396706669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14245 LEE HWY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024317",
            "telephone_number": "276-628-8164",
            "fax_number": "276-644-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245 LEE HWY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024317",
            "telephone_number": "276-628-8164",
            "fax_number": "276-644-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD D JESSUP DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "JESSUP",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-628-8164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "1223G0001X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164996",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Bristol, VA
• Providers in Bristol, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.