Individual provider Active NPI

Jefferson Draughn Whitehead Jr., DDS

  • General Practice Dentistry
  • Fuquay Varina, NC
National Provider Identifier
1598816241
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4273 Issued in NC
Practice address
1213 N Main St
Fuquay Varina, NC 27526-2616
Phone
(910) 814-2944
NPI assigned
Jan 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4273 NC Primary

Addresses

Primary practice location

1213 N Main St
Fuquay Varina, NC 27526-2616

Mailing address

PO Box 2227
Lillington, NC 27546-2227
Phone (910) 814-2944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160628000196 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1153311261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates I DDS PA General Practice Past Accepting new patients
Lane & Associates X DDS PA General Practice PastSince Feb 1, 2023 Accepting new patients
Lane and Associates V, DDS PA General Practice Past Accepting new patients
Lane and Associates VI DDS PA General Practice PastSince Aug 13, 2023 Accepting new patients
Lane and Associates IX DDS PA General Practice PastSince Feb 26, 2023 Accepting new patients
Don G Lane II,DDS,PLLC Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598816241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2227",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275462227",
            "telephone_number": "910-814-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262616",
            "telephone_number": "910-814-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "JEFFERSON",
        "middle_name": "DRAUGHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.