Jeffrey Dental Clinic PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JEFFREY DENTAL CLINIC PLLC

Practice address

304 Glen Ave
Valparaiso, FL 32580-1233

Phone

(850) 678-4151

NPI assigned

Jul 2, 2015

Last updated

Jul 30, 2024By 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

McKinzie Dawn Jeffrey, DDSNPI 1073996757

Title

Owner

Phone

(850) 678-4151

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• McKinzie Jeffrey, D.D.S.

  • Dentist
  • Valparaiso, FL
  • NPI 1073996757
  NPD Authorized official
• Alex J. Jeffrey, D.D.S.

  • Dentist
  • Valparaiso, FL
  • NPI 1093181232
  NPD
• Shawn A. Mitchell, D.M.D.

  • General Practice Dentistry
  • Valparaiso, FL
  • NPI 1780622647
  NPD (past)

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1528441003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 GLEN AVE",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801233",
            "telephone_number": "850-678-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 GLEN AVE",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801233",
            "telephone_number": "850-678-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY DENTAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "JEFFREY",
        "authorized_official_first_name": "MCKINZIE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-678-4151",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Cameron Griffin, LMHC
• Growing Green Families, PLLC
• Kavitha Prasad Hardy, M.D.
• Sherrel Hill, BCBA
• I3M Wellness LLC
• Alex J. Jeffrey, D.D.S.
• McKinzie Jeffrey, D.D.S.
• Deborah Marie Jerrells, DMD
• Lois J. Lunderman, DDS, PA
• Lynsie Rae Lopiccolo

• General Practice Dentistry in Valparaiso, FL
• Providers in Valparaiso, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.