Individual provider Active NPI

Jeffery P Hreha, DDS, MSD.

  • Endodontics
  • Sedona, AZ
National Provider Identifier
1780804294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D4301 Issued in AZ
Practice address
1120 W Highway 89a Ste B4
Sedona, AZ 86336-5767
Phone
(928) 204-9213
Fax
(928) 204-9215
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D4301 AZ Primary

Addresses

Primary practice location

1120 W Highway 89a Ste B4
Sedona, AZ 86336-5767

Mailing address

1120 W Highway 89a Ste B4
Sedona, AZ 86336-5767
Phone (928) 204-9213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522000860 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345403796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4301AZMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Sedona Endodontics, LTD Endodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780804294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W HIGHWAY 89A STE B4",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365767",
            "telephone_number": "928-204-9213",
            "fax_number": "928-204-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W HIGHWAY 89A STE B4",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365767",
            "telephone_number": "928-204-9213",
            "fax_number": "928-204-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HREHA",
        "first_name": "JEFFERY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D4301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedona, AZ

Sources for this page

Verify at the official NPI Registry.