Thomas S Jeter, MD, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

F1680 Issued in TX

Practice address

303 W Harris Ave
Ste 2
San Angelo, TX 76903-6377

Phone

(325) 658-6519

Fax

(325) 658-6510

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Privia Medical Group West Texas, PLLC

  dba Abilene Diagnostic Clinics

  • Podiatrist
  • Abilene, TX
  • NPI 1043725062
  NPD (past)
• Privia Medical Group West Texas, PLLC

  dba Abilene Diagnostic Clinic, PLLC

  • Specialist
  • Abilene, TX
  • NPI 1346242567
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1740282748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W HARRIS AVE STE 2",
            "address_2": "P O BOX 3602",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036377",
            "telephone_number": "325-658-6519",
            "fax_number": "325-658-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W HARRIS AVE",
            "address_2": "STE 2",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036377",
            "telephone_number": "325-658-6519",
            "fax_number": "325-658-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "THOMAS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "9602",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "F1680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00T570",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth M Jastrow III, M.D
• Carol J Jeffers, LPC MASTERS DEGREE
• Joe Mac Jeffers, ED.D.
• Jose Jenks, PHARMD
• Jennifer M Moss (Concho Valley OB-GYN)
• Tresea M Jeter, FNP-C
• Joshua Jibben, LCDC-I
• Jim Dandy Medical Inc
• Jim W. Collier, Dcpa (Southwest Back Clinic)
• Lydia J Jimenez, MS

• Oral & Maxillofacial Surgery (D.M.D.) in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.