Bethaniel S Jefferson, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BETHANIEL S JEFFERSON, DDS, PC

Practice address

15531 Kuykendahl Rd
Ste 180
Houston, TX 77090-3645

Phone

(281) 895-7787

NPI assigned

Feb 7, 2008

Organization subpart

No

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

Authorized official

Name

Bethaniel JeffersonNPI 1447240825

Title

Owner

Phone

(281) 895-7787

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bethaniel Jefferson, DDS

  • General Practice Dentistry
  • Houston, TX
  • NPI 1447240825
  NPD (past) Authorized official

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1487832945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15531 KUYKENDAHL RD",
            "address_2": "STE 180",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15531 KUYKENDAHL RD",
            "address_2": "STE 180",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903645",
            "telephone_number": "281-895-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANIEL S JEFFERSON, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "BETHANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-895-7787"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Houston, TX
• Providers in Houston, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.