Jefferson Lamar Newbern IV, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.027009 Issued in OH

Practice address

3609 N Dixie Dr
Dayton, OH 45414-5232

Phone

(229) 560-5494

Fax

(937) 278-8232

NPI assigned

May 28, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

State licenses

Practice roles

Locations

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.

• Jefferson Newbern, DMD, PLLC

  • Dental Clinic/Center
  • Dayton, OH
  • NPI 1952119174
  NPD Authorized official
• Jefferson Newbern, DMD, PLLC

  • General Practice Dentistry
  • Elizabethtown, KY
  • NPI 1467879031
  NPD

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1497074504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 N DIXIE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145232",
            "telephone_number": "229-560-5494",
            "fax_number": "937-278-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 N DIXIE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145232",
            "telephone_number": "229-560-5494",
            "fax_number": "937-278-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERN",
        "first_name": "JEFFERSON",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8866",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Phoenix
• New Reflections Counseling, Inc.
• New Revelation of Christ Church Ministries
• New Season of Ohio, LP
• Selim Newaz, MD
• Davonna Newberry
• Ronda Newberry
• Claudette Michelle Newell
• Darrin Newell
• Samantha Newham, ATC, LPC

• Dentist in Dayton, OH
• Providers in Dayton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.