Individual provider Active NPI

Jonathan C Huffman, D.D.S.

  • General Practice Dentistry
  • Salisbury, NC
National Provider Identifier
1790700888
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7443 Issued in NC
Practice address
304 Statesville Blvd
Salisbury, NC 28144-2316
Phone
(704) 637-0773
Fax
(704) 637-0251
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 7443 NC Primary

Addresses

Primary practice location

304 Statesville Blvd
Salisbury, NC 28144-2316

Mailing address

304 Statesville Blvd
Salisbury, NC 28144-2316
Phone (704) 637-0773

Other identifiers 1

IdentifierTypeStateIssuer
89902E2MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160628003196 NC Order and Referring Only - DentistPractitioner - Dentist 2365733995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7443NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan C. Huffman DDS PA General Practice 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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790700888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 STATESVILLE BLVD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442316",
            "telephone_number": "704-637-0773",
            "fax_number": "704-637-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 STATESVILLE BLVD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442316",
            "telephone_number": "704-637-0773",
            "fax_number": "704-637-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902E2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.