Jesse Allen Stafford, D.D.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

9243 Issued in NC

Practice address

516 W Arapaho Rd Ste 103
Richardson, TX 75080-4342

Phone

(972) 231-5020

NPI assigned

Aug 3, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Comfort Dental Richardson, PLLC

  • General Practice Dentistry
  • Richardson, TX
  • NPI 1780984922
  NPD (past)

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1669786430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "PLUMTREE",
            "state": "NC",
            "postal_code": "28664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W ARAPAHO RD STE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804342",
            "telephone_number": "972-231-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "JESSE",
        "middle_name": "ALLEN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "32443",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NC",
            "license": "9243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919824",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Srxptx1 LLC
• St M Health PLLC
• Lilian St. John, MD
• Beverly Ann St. Onge, MS, CCC-SLP
• Whitney Ashlyn Russell Stabile, LPC-S
• Ellen Rebecca Stamerjohn, RDN, LD
• Stampe Dental, PA
• Melody A Stampe, DDS
• Kimberly Stanley, CNIM
• Lindsey Stanley

• Prosthodontics in Richardson, TX
• Providers in Richardson, TX by specialty
• Prosthodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.