Jeanie F Kaufman, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

28339 Issued in CA

Practice address

1077 4TH St
South Lake Tahoe, CA 96150-3459

Phone

(530) 541-1353

Fax

(530) 541-3229

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

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 and National Provider Directory roles.

• Darryl T. Azouz, D.D.S., Inc.

  • Dental Clinic/Center
  • South Lake Tahoe, CA
  • NPI 1467213918
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1740498252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 4TH ST",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503459",
            "telephone_number": "530-541-1353",
            "fax_number": "530-541-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 4TH ST",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503459",
            "telephone_number": "530-541-1353",
            "fax_number": "530-541-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JEANIE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "28339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Juckett
• Richard Leland Kahn, OD
• Watson Kambenja
• Alyna Azalia Vera Kane
• Nicole Karetov, RD
• Raoul L Kaufman, MARRIAGE FAMILY THER
• Linda Penney Keel, PH.D.
• Brian N Kelly, PT
• Christianne Bijasa Kernes, LMFT
• Jessica Keys, RD

• Dentist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.