Jared Carter Packard, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61554 Issued in CA

Practice address

725 Grand Ave
Carlsbad, CA 92008-2331

Phone

(760) 729-4904

Fax

(760) 729-0513

NPI assigned

Jul 19, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

• Packard Dental Group Inc

  • Dentist
  • Carlsbad, CA
  • NPI 1861585804
  NPD (past)
• Packard Dental Group Inc.

  • Customized Equipment (DME)
  • Carlsbad, CA
  • NPI 1174955868
  NPD (past)

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1649525247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GRAND AVE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082331",
            "telephone_number": "760-729-4904",
            "fax_number": "760-729-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GRAND AVE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082331",
            "telephone_number": "760-729-4904",
            "fax_number": "760-729-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "JARED",
        "middle_name": "CARTER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald George Pack, D.C.
• Packard Dental Group Inc
• Packard Dental Group Inc.
• Packard Dental Partnership
• Forrest L Packard, DDS
• Mark D Packard, DMD
• Matthew Stephen Packard, DDS
• Paczkowski Physical Therapy, Apc (Inside Out Strength and Performance)
• Lindsey Paczkowski, DPT
• Joseph Padgett

• General Practice Dentistry in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.