Ronald Joe Jessup, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401006621 Issued in VA

Practice address

1165 Jefferson Green Circle
Midlothian, VA 23113

Phone

(804) 379-7864

Fax

(804) 379-4295

NPI assigned

May 15, 2007

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

Other names 1

• Dr. Ronald J Jessup Other name

Medicare fee-for-service enrollment

Enrolled in VA

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.

• Sycamore Family Dentistry

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1609520535
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1497961593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 JEFFERSON GREEN CIRCLE",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-379-7864",
            "fax_number": "804-379-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 JEFFERSON GREEN CIRCLE",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-379-7864",
            "fax_number": "804-379-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "RONALD",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "JESSUP",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "DDS PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer L Perkinson
• Charlotte Jennings, APRN, FNP-BC
• Jenny Alsop, OD PLLC
• Christian Jenski, M.D.
• Jeryl a Abbott DDS PC
• Ashif K Jethava, MD
• Patricia Diane Jiggetts
• Bogale Jima, MD
• JL Butterfly Estates
• Kristen Marie Joback, LPC

• Dentist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.