Jacquelyn Jeanne Freeman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00202088 Issued in CO

Practice address

1460 W Moore Rd
Oro Valley, AZ 85755-8888

Phone

(520) 247-7341

NPI assigned

Aug 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 28, 2022 through Nov 28, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1679906622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 W MOORE RD",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857558888",
            "telephone_number": "520-247-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 W MOORE RD",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857558888",
            "telephone_number": "520-247-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "JACQUELYN",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00202088",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forefront Dermatology, S.C.
• Amanda J Foxe, DPT
• Kagran Franco
• Frank Emmert DDS PLLC
• Kimberly Ann Frazier, APRN, CRNA
• Larissa E Freytag, D.M.D.
• David Jay Friedman, MD
• Fully Wired Inc
• Patrycja Monika Furga-Ngako, FNP-C
• Omar Arif Gafur

• General Practice Dentistry in Oro Valley, AZ
• Providers in Oro Valley, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.