Individual provider Active NPI

Jeff Nerio, D.D.S., M.S.

  • Periodontics
  • Puyallup, WA
National Provider Identifier
1467546895
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE00007119 Issued in WA
Practice address
315 39TH Ave SW
Suite 1
Puyallup, WA 98373-3690
Phone
(253) 845-5456
Fax
(253) 848-0141
NPI assigned
Oct 2, 2006
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
Periodontics 1223P0300X DE00007119 WA Primary

Addresses

Primary practice location

315 39TH Ave SW
Suite 1
Puyallup, WA 98373-3690

Mailing address

315 39TH Ave SW
Suite 1
Puyallup, WA 98373-3690
Phone (253) 845-5456

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DE00007119WAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeff Nerio,DDS,Ms,PS,Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467546895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 39TH AVE SW",
            "address_2": "SUITE 1",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733690",
            "telephone_number": "253-845-5456",
            "fax_number": "253-848-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 39TH AVE SW",
            "address_2": "SUITE 1",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733690",
            "telephone_number": "253-845-5456",
            "fax_number": "253-848-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERIO",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE00007119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

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.