Individual provider Active NPI

Jason Lawrence Barrett, DDS

  • General Practice Dentistry
  • Mount Airy, NC
National Provider Identifier
1649607946
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13166 Issued in NC
Practice address
161 Kodiak LN
Mount Airy, NC 27030-5399
Phone
(336) 789-1025
Fax
(336) 789-1158
NPI assigned
Oct 1, 2013
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15405 MD
General Practice Dentistry 1223G0001X 13166 NC Primary

Addresses

Primary practice location

161 Kodiak LN
Mount Airy, NC 27030-5399

Mailing address

161 Kodiak LN
Mount Airy, NC 27030-5399
Phone (336) 789-1025

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jason.l.barrett.mil@health.mil Direct

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
I20230720000818 NC Order and Referring Only - DentistPractitioner - Dentist 5698135713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15405MDMDPhysical Therapist
13166NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason L Barrett DDS PLLC Current Accepting new patients
Lane and Associates Xxxix DDS PA Dentist CurrentSince Jul 16, 2023 Accepting new patients

Locations

4380 S Syracuse St
Ste 504
Denver, CO 80237
Phone (303) 741-1011

161 Kodiak Ln
Mount Airy, NC 27030
Phone (336) 719-7129

Organizations & group practices 2

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": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1649607946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 KODIAK LN",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305399",
            "telephone_number": "336-789-1025",
            "fax_number": "336-789-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 KODIAK LN",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305399",
            "telephone_number": "336-789-1025",
            "fax_number": "336-789-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "JASON",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15405",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.l.barrett.mil@health.mil",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "Naval Medical Readiness and Training Unit - Norfolk",
            "address_2": "1647 Admiral Taussig Blvd",
            "city": "Norfolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.