NPIMap

Organization Active NPI

Jason C. Campbell DDS.

  • Dentist
  • Prescott, AZ
National Provider Identifier
1649408576
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6176 Issued in AZ
Legal business name
JASON C. CAMPBELL DDS.
Practice address
139 Whipple St
Prescott, AZ 86301-1705
Phone
(928) 776-1208
Fax
(928) 541-9648
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Mrs. Sue Privette
Title
Office Manager
Phone
(928) 776-1208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6176 AZ Primary

Addresses

Primary practice location

139 Whipple St
Prescott, AZ 86301-1705

Mailing address

139 Whipple St
Prescott, AZ 86301-1705
Phone (928) 776-1208

National Provider Directory

National Provider Directory

Locations

139 Whipple St
Prescott, AZ 86301
Phone (928) 776-1208

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1649408576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011705",
            "telephone_number": "928-776-1208",
            "fax_number": "928-541-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011705",
            "telephone_number": "928-776-1208",
            "fax_number": "928-541-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON C. CAMPBELL DDS.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "PRIVETTE",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-776-1208",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "6176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.