Active NPI
Raushanah Taherrah Shareef-Jefferson, RDH, IBCLC
- Dental Hygienist
- Grand Prairie, TX
National Provider Identifier
1689136624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 13480
- Practice address
- 831 Ridgecrest Rd
Grand Prairie, TX 75052 - Phone
- (972) 795-7422
- NPI assigned
- Apr 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-108268 | ||
| Dental Hygienist | 124Q00000X | 13480 | TX | Primary |
Addresses
Primary practice location
831 Ridgecrest Rd
Grand Prairie, TX 75052
Mailing address
831 Ridgecrest Rd
Grand Prairie, TX 75052
Phone (972) 795-7422
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13480 | TX | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554076800000",
"number": "1689136624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "831 RIDGECREST RD",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "75052",
"telephone_number": "972-795-7422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 RIDGECREST RD",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "75052",
"telephone_number": "972-795-7422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAREEF-JEFFERSON",
"first_name": "RAUSHANAH",
"middle_name": "TAHERRAH",
"credential": "RDH, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-01",
"last_updated": "2019-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": "L-108268",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TX",
"license": "13480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.