Active NPI
Jennifer Elmer, DDS
- Dentist
- Visalia, CA
National Provider Identifier
1659623973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61654
- Practice address
- 30979 Road 67
Visalia, CA 93291-9303 - Phone
- (559) 651-2301
- Fax
- (559) 651-1584
- NPI assigned
- Oct 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61654 | CA | Primary |
Addresses
Primary practice location
30979 Road 67
Visalia, CA 93291-9303
Mailing address
30979 Road 67
Visalia, CA 93291-9303
Phone (559) 651-2301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61654 | Other | CA | DENTAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61654 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare Network | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Delano, CA
- NPI 1063283158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1659623973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30979 ROAD 67",
"city": "VISALIA",
"state": "CA",
"postal_code": "932919303",
"telephone_number": "559-651-2301",
"fax_number": "559-651-1584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30979 ROAD 67",
"city": "VISALIA",
"state": "CA",
"postal_code": "932919303",
"telephone_number": "559-651-2301",
"fax_number": "559-651-1584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMER",
"first_name": "JENNIFER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-10",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61654",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "61654",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.