Jessica Lucille Weaver, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN15076 Issued in FL

Practice address

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

Phone

(210) 292-0720

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1750401543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-0720"
        },
        {
            "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": "210-292-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JESSICA",
        "middle_name": "LUCILLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15076",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "D15076",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jessica.l.weaver19.mil@mail.mil",
            "affiliation": "Y",
            "endpointDescription": "military email",
            "affiliationName": "united states air force",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "MTF",
            "address_1": "436 MDG",
            "address_2": "300 Tuskegee Blvd",
            "city": "Dover AFB",
            "state": "DE",
            "country_code": "US",
            "postal_code": "19962",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.l.weaver19.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "DOD email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "MTF",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "436 MDG",
            "address_2": "300 Tuskegee Blvd",
            "city": "Dover AFB",
            "state": "DE",
            "country_code": "US",
            "postal_code": "19962",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.l.weaver19.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "DOD email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "436 MDG",
            "address_2": "300 Tuskegee Blvd",
            "city": "Dover AFB",
            "state": "DE",
            "country_code": "US",
            "postal_code": "19962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jane Sueko Wallace, DDS
• Colby Elizabeth Norris Walton, MD
• Bryce Warren, MD, PHD
• Rachel M Washington, PA
• Maryann Wasileski, PH.D.
• Mary A Webb, PA-C
• Rachel Weber, DDS
• Thomas Kirk Weber, D.D.S.
• Jeffrey Lewis Webster, DMD
• Daniel Allan Weidner, DO

• 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 Oct 17, 2022; 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.