Jeffrey Jerome Caldwell Sr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5898 Issued in NC

Practice address

405 S McCaskey Rd Ste C
Williamston, NC 27892-2160

Phone

(252) 792-1101

Fax

(252) 792-1102

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

• Jeffrey J. Caldwell, Sr., D.D.S., P.a.

  • General Practice Dentistry
  • Williamston, NC
  • NPI 1013014380
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740388958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S MCCASKEY RD STE C",
            "address_2": "P. O. BOX 621",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922160",
            "telephone_number": "252-792-1101",
            "fax_number": "252-792-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S MCCASKEY RD STE C",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922160",
            "telephone_number": "252-792-1101",
            "fax_number": "252-792-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JEFFREY",
        "middle_name": "JEROME",
        "name_suffix": "Sr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8991301",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Pauline Bundrick, CRT, RCP
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• Wan Soo Chung, MD

• General Practice Dentistry in Williamston, NC
• Providers in Williamston, NC by specialty
• General Practice Dentistry in North Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.