Harvey M Jaffe, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30. 015162 Issued in OH

Practice address

790 Broadway Ave
Bedford, OH 44146-3645

Phone

(440) 439-1221

Fax

(440) 439-8449

NPI assigned

Dec 5, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568520302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 BROADWAY AVE",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441463645",
            "telephone_number": "440-439-1221",
            "fax_number": "440-439-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 BROADWAY AVE",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441463645",
            "telephone_number": "440-439-1221",
            "fax_number": "440-439-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "HARVEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30. 015162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0305842",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chanel Jackson, STNA
• Kathleen Jackson
• William Jackson Jr.
• Diane Marie Jacobs, RN
• Kelli Marie Jacobs, LMT
• Robert James Jr.
• Jane L. Dodson DDS & Assoc., Inc.
• Megan Jaworski
• Brittany Jay Reed
• Jessica Transportation LLC

• General Practice Dentistry in Bedford, OH
• Providers in Bedford, OH by specialty
• General Practice Dentistry in Ohio

• 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.