Jeffrey Jelic, MD

Primary specialty

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

License

9900887 Issued in NC

Practice address

508 Fulton St
Durham, NC 27705-3875

Phone

(909) 286-6960

NPI assigned

Jun 25, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• The Center for Functional & Aesthetic Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Durham, NC
  • NPI 1881761583
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750317178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "909-286-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELIC",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "9900887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sedra Lenece Jefferys, LCSW-A
• Jeffrey R. Chambers, M.D., P.a.
• Jeffrey R. Chambers, MD, PA
• Courtney J Jeffries, PT, DPT, NCS
• Nicole Elise Jelesoff, MD
• Stephanie Theresa Jenal, PH.D.
• Anna Stone Jenkins
• Brittany Anne Jenkins, LCMHCA
• Devon Jenkins
• Elizabeth Louise Jenkins, LMT

• Oral & Maxillofacial Surgery (D.M.D.) in Durham, NC
• Providers in Durham, NC by specialty
• Oral & Maxillofacial Surgery (D.M.D.) 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.