Jeffrey Maris Dyke, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

33391 Issued in TX

Practice address

5243 Snapfinger Woods Dr Ste 106
Decatur, GA 30035-4000

Phone

(770) 981-9400

NPI assigned

Jul 7, 2017

Last updated

Jul 6, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Oral Surgery Associates & Dental Implant Center PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Conyers, GA
  • NPI 1003924788
  NPD
• Austin Oral & Maxillofacial Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Austin, TX
  • NPI 1508875147
  NPD (past)

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1659893071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E JOHN CARPENTER FWY STE 660",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623543",
            "telephone_number": "469-284-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5243 SNAPFINGER WOODS DR STE 106",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354000",
            "telephone_number": "770-981-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKE",
        "first_name": "JEFFREY",
        "middle_name": "MARIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "33391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Dworetz
• Joseph T. Dye, RPH, PHD
• Richard William Dye, DC
• Julie Dyer, NNP
• James Spencer Dyke, PT, DPT
• Dynamic Rehab Solutions, LLC (Dynamic Rehabilitaion Solutions, LLC)
• Eac Services LLC (Emory Autism Center)
• Lamecia E'Sonya Eaddy, MSW, LCSW
• Aundrea Vereen Eady, DMD
• Stephanie L Earle

• Oral and Maxillofacial Surgery (Dentist) in Decatur, GA
• Providers in Decatur, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.