Jeffrey P Jessup, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15997 Issued in TX

Practice address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Phone

(210) 292-0123

NPI assigned

Sep 1, 2005

Last updated

Jan 19, 2021By 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

State licenses

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1750375093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 PEPPERRELL ST BLDG 3352",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365313",
            "telephone_number": "210-292-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Irwin, D.D.S., MPH
• Norris Jackson, MD
• Bonnie Lynn Jago, CRNA
• Shreya Jain
• Princess Erika Javier-Anderson
• Liza Lamar Jimenez, PHARM D.
• Alexander Hai Jin
• Andrew Johnson, PT, DPT, SCD
• Brent A. Johnson, D.P.M.
• Latoya Johnson, PA-C

• General Practice Dentistry in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.