Jeffrey A Englestadter, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D7225 Issued in OR

Practice address

2800 Foothills Blvd
Klamath Falls, OR 97603-3768

Phone

(541) 883-7409

Fax

(541) 850-8672

NPI assigned

May 24, 2007

Last updated

Jul 8, 2007By 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

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeffrey a. Englestadter, DMD, PC

  • Dental Clinic/Center
  • Klamath Falls, OR
  • NPI 1780741884
  NPD (past) Authorized official
• Michael C. Thomas, DMD, PC

  • Dental Clinic/Center
  • Klamath Falls, OR
  • NPI 1932266020
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710198395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 FOOTHILLS BLVD",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976033768",
            "telephone_number": "541-883-7409",
            "fax_number": "541-850-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 FOOTHILLS BLVD",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976033768",
            "telephone_number": "541-883-7409",
            "fax_number": "541-850-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLESTADTER",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty R Elrod, PSS
• Heather Joan Emel, OTR/L
• Emeritus Corporation (Brookdale Klamath Falls)
• Thomas Endicott, RPH
• Elyse Englestadter
• Barbara G Enos, RN, PMHNP
• Gregory D. Enos, L.AC.
• Konrad J Eppel, MD
• Equity Dental Clinics Klamath, LLC
• Debra Matteson Ernst

• Dentist in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.